Difference In Time Research Articles

Differences in soil water movement between the dip and anti-dip slopes of a karst trough valley

Exploring temporal and spatial variations in soil water processes is crucial for identifying the ecological water supply capacity of soil and understanding hydrologic cycles within karst catchments. However, the existing body of knowledge related to soil water dynamics across dip and anti-dip slopes in karst landscapes remains limited. To address this gap, this study investigated soil water dynamics in a karst trough valley (KTV) in southwest China, using stable isotopes (δD and δ18O) from eight sampling sites and precipitation data from April 2017 to November 2018. Our findings suggest that seasonal variations in soil water isotopes are primarily influenced by climatic factors, with soil water lagging behind rainwater isotopes by one to four months due to differences in the residence time of precipitation in different soil layers. Spatially, our results reveal the coexistence of diffuse and preferential flows on both dip and anti-dip slopes. Specifically, on the dip slope, preferential flow dominates above 20 cm, while diffuse flow prevails below this depth. In contrast, on the anti-dip slope, preferential flow is prominent above 40 cm depth, while diffuse flow dominates beneath this threshold. These spatial patterns not only impact the ecological water and nutrient supply capacity of soil but they also contribute to distinct patterns in vegetative growth on both slopes. In turn, vegetation growth facilitates preferential flow pathways, establishing a positive feedback loop between soil water movement and vegetative cover. These findings may lead to a deeper understanding of soil water processes on the dip and anti-dip slopes of KTVs and provide crucial insights into the relationship between soil water and vegetative growth in similar karst landforms.

Posterior crossbite corrections in the early mixed dentition with quad helix or rapid maxillary expander: a cost-effectiveness analysis of a randomized controlled trial.

Unilateral posterior crossbite is a common malocclusion, and early treatment is recommended to enable normal growth. There are several possibilities regarding choice of appliances used for correcting this malocclusion; however, when treatment is financed by public funds the decision needs to be based not only on the effects but also on the effect in relation to the costs. The aim was to perform a cost-effectiveness analysis comparing quad helix (QH) and rapid maxillary expanders (RME; hyrax-type) in children in the early mixed dentition. Seventy-two patients were randomized to treatment with either QH or RME, at two different centres. Data were collected from the patient's medical records regarding success rate, number of visits, total treatment time, emergency visits, and so forth, together with answers from patient questionnaires concerning absence from school and use of analgesics. A cost-effectiveness analysis with both an intention-to-treat (ITT) and a per-protocol approach was performed, as well as a deterministic sensitivity analysis. The success rate, one year after the completion of the expansion, was equal between groups according to the ITT approach. From a healthcare perspective, the mean cost difference between RME and QH was €32.05 in favour of QH (P = 0.583; NS). From a societal perspective, the mean cost difference was €32.61 in favour of QH (P = 0.742; NS). The total appliance cost alone was higher in the RME group €202.67 resp. €155.58 in the QH group (P = 0.001). The probability of RME having a higher cost was 71% from a healthcare perspective and 62.7% from a societal perspective. The total treatment time was 97 days longer in the QH group. In the deterministic sensitivity analysis, when using a higher valuation of the children's educational loss, the QH becomes €58 more costly than the RME. There was a statistically significant difference in chair time and visits between centres (P < 0.001). The difference in costs between RME and QH is not statistically significant, however, there is a slightly higher probability that RME is more expensive than QH with a mean cost of an additional €32 per patient from a healthcare perspective. Different work procedures at different centres indicate that logistics around the patient's treatment is a more important aspect than appliance used to decrease the number of visits and save chair time and thereby also costs.

The association of the dietary inflammatory potential with risk of overall and site-specific cancers: A community-based longitudinal study in the UK Biobank

ObjectivesThe association of the dietary inflammatory potential with cancer risk remains uncertain. We examined the relationship of the dietary inflammatory potential with risk of overall and site-specific cancers and explored its sex and age differences. DesignA community-based longitudinal study. SettingParticipants from the UK Biobank completed baseline surveys during 2006–2010 and were followed for up to 15 years to detect incident cancer. Participants170,899 cancer-free participants with dietary data available (mean age: 55.73 ± 7.95, 54.10% female). MeasurementsAt baseline, dietary intake was assessed with a 24-h dietary record for up to 5 times. The inflammatory diet index (IDI) was calculated to assess the dietary inflammatory potential as a weighted sum of 31 food groups (including 14 anti-inflammatory and 17 pro-inflammatory) based on plasma high-sensitivity C-reactive protein (hsCRP) levels, and tertiled as low (indicating low-inflammatory diet), moderate, and high IDI (as reference). Overall and site-specific cancers were ascertained via linkage to routine hospital admission, cancer registry, and death certificate data. Data were analyzed using Cox regression and Laplace regression. ResultsDuring the follow-up (median 10.32 years, interquartile range: 9.95–11.14 years), 18,884 (11.05%) participants developed cancer. In multi-adjusted Cox regression, low IDI scores were associated with decreased risk of rectal cancer (hazard ratio [95% confidence interval, CI] 0.76 [0.61, 0.94]), thyroid cancer [0.45 (0.27, 0.74)], lung cancer [0.73 (0.61, 0.88)]. However, the association between IDI score and the risk of overall cancer was not significant. Laplace regression analysis showed that 10th percentile differences (95% CIs) of cancer onset time for participants with low IDI scores was prolonged by 1.29 (0.32, 2.27), 1.44 (0.58, 2.30), and 2.62 (0.98, 4.27) years for rectal cancer, thyroid cancer, and lung cancer, respectively, compared to those with high IDI scores. Stratified analysis revealed that low IDI scores were associated with a lower risk of rectal cancer (p interaction between IDI score and sex = 0.035) and lung cancer in males, but not in females, and with a reduced risk of thyroid cancer in females, but not in males. Moreover, low IDI scores were associated with a reduced risk of rectal cancer and lung cancer in the participants aged ≥60 years, but not in those <60 years, and with a reduced risk of thyroid cancer in those aged ≥60 years and <60 years. ConclusionsA low-inflammatory diet is associated with decreased risk and prolonged onset time of rectal cancer and lung cancer, especially among males and individuals aged ≥60 years, and thyroid cancer among females.

Vascularity evaluation of the equine tarsocrural and proximal intertarsal joint septum, and comparative analysis of two arthroscopic transection techniques.

To evaluate vascularity of the synovial membrane covered septum (SMS) separating the tarsocrural (TC) and proximal intertarsal (PIT) joints (Part 1) and compare two methods of transection, electrosurgical or Ferris Smith rongeur (FS rongeur) (Part 2). Experimental study. Part 1, 10 SMS (n = 5 horses). Part 2, six horses (n = 12 tarsi). In part 1, SMS harvested postmortem were each divided into eight regions of interest (ROIs), processed for histology, and immunostained with anti-α-actin antibody for blood vessel identification. Vascular density was calculated for each ROI. Data was compared within and between horses. In part 2, six horses underwent TC arthroscopy. Each limb was randomly assigned to undergo either electrosurgical or FS rongeur SMS transection. SMS transection and total operative time were recorded. Intraoperative hemorrhage was scored. Data was compared between both techniques. Significant interindividual variations in SMS vascular density were detected (p = .02), but there were no differences among ROIs. No differences in the transection time were detected between electrosurgery (4.83 ± 0.54 min) and FS rongeur (4.33 ± 0.67 min). No differences were found in intraoperative hemorrhage scores between techniques. Vascularity within the SMS varies among horses but not within its regions. Electrosurgical or FS rongeur transection of the medial SMS during tarsocrural arthroscopy is a rapid technique and improves surgical access to the dorsal compartment of the PIT.

Effect of Argentine tango sessions on total physical activity time in patients with chronic inflammatory rheumatism: randomized, controlled, pilot study.

The aim of this study was to evaluate the effect of an Argentine Tango (AT) program on total physical activity (PA) time in patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA). Prospective randomized controlled pilot study with two parallel groups. Participants were randomized 1:1 to attend a 24-week AT program from baseline to month6 for the immediate tango group (ITG) and a 12-week AT program from month3 to month6 for the wait-list control group (WLCG). Total PA time was measured at baseline, month3, and month6 using the Global Physical Activity Questionnaire-ONAPS and an accelerometer. Twenty-seven participants (15 RA and 12 SpA) were enrolled in the study. Thirteen participants in the WLCG and 14 in the ITG. At month3, there was no significant difference in the total PA time between the two groups. Longitudinal analyses revealed no significant difference between the two groups regarding PA, sedentary, fatigue, anxiety, depression, balance, physical performance, pain, and stress. However, body appreciation improved significantly in the ITG compared with the WLCG. Both groups showed improved physical abilities at 6month, including improvements in the 6-min walk test and timed up and go test. The ITG also reported reduced pain at months 3 and 6, while the WLCG exhibited improved balance at month 6. Although the AT program did not significantly increase total PA time in patients with CIR, it positively impacted body appreciation and physical abilities suggesting its potential as a complementary therapy. Key Points • Body appreciation significantly improved after a 24-week AT program, emphasizing the positive impact of dance on self-perception. • Both groups exhibited improved physical abilities at month 6, indicating a positive influence on participants' overall mobility and functional capacity. • The 24-week AT group reported reduced pain at months 3 and 6, and the 12-week AT group exhibited improved balance at month 6.

The pathological characteristics and prognostic analysis of medullary thyroid microcarcinoma

Objectives: To analyze the clinical characteristics and prognosis of medullary thyroid microcarcinoma (MTMC). Methods: A case series studies. The clinical data of patients with medullary thyroid carcinoma (MTC) diagnosed by postoperative pathology and with complete follow-up data who were initially treated in Tianjin Medical University Cancer Hospital from January 2013 to December 2019 were retrospectively analyzed. There were a total of 170 cases, including 70 males and 100 females, aged (49.7±12.3) years old. Among them, there were 61 patients with MTMC. They were divided into group A (with a maximum tumor idameter of ≤0.5 cm, n=13) and group B (with a maximum tumor diameter >0.5~≤1.0 cm, n=48) based on whether the maximum diameter of the tumor was >0.5 cm. Analysis was conducted on their pathological results and prognosis. Results: Among the MTC, MTMC accounted for 26.4% (61/231) with 26 males and 35 females aged M［Q1，Q3］51.0 (41.0, 59.0) years. Among the MTMC patients, 57.4% (35/61) were in stage Ⅰ, 16.4% (10/61) were in stage Ⅲ, and 26.2% (16/61) were in stage Ⅳ. For MTMC with a maximum diameter of≤0.5 cm and a maximum diameter of >0.5-≤1.0 cm, there was no statistically significant difference between the two groups in terms of gender, age, mixed cancer, invasion of glandular lobes, multifocal, central lymph node metastasis, lateral neck lymph node metastasis rate and other pathological characteristics(both P>0.05). In terms of prognosis, the recurrence free survival time of MTMC patients was 83.1 (68.0, 97.0) months. Among them, structural tumor recurrence occurred in 5 patients (8.2%) after surgery, and 1 patient (1.6%) died. The expected 5-year and 10-year survival rates were 93.4% and 89.0%, respectively. There was no statistically significant difference in recurrence free survival time among MTMC patients, MTC patients with a maximum diameter of >1.0-≤2.0 cm, and MTC patients with a maximum diameter of >2.0 cm (all P>0.05). Conclusion: MTMC has strong invasiveness, and although the prognosis of most MTMCs is relatively good, the risk of long-term recurrence and death is still high.

Investigation of compound occurrence of storm surge and river flood in Mikawa Bay, Japan, using typhoon track ensemble experiments

The risk of high river flow and peak storm surge superimposing in the estuary of small-and medium-sized rivers can be more severe during typhoon landfalls than at other times. In this study, 30 cases of typhoon track ensemble experiments for five rivers in Mikawa Bay, Japan, were evaluated using an atmospheric-river-ocean model. The results showed that storm surges coincided with high river flows when typhoons crossed the western side of Mikawa Bay, with the highest potential observed when typhoons passed northwest of the Bay. The average time discrepancy for the five rivers between the storm surge occurrence and increased river flow in the minimum time difference case was 48 min at the river mouth. Distinct trends in the time difference between a storm surge and river flow were observed for each river mouth. The order of time differences corresponded to the drainage area scale: Toyo (188 min), Umeda (112 min), Otowa (114 min), Sana (96 min), and Yagyu (88 min). Time difference trends also varied based on the distance between the typhoon center and each river mouth. For Toyo River, storm surges and high river flows did not substantially overlap, regardless of distance. However, for medium-and small-sized rivers, the time difference increased proportionally with the distance from the typhoon. The Yagyu River showed the highest potential for compound occurrence of a storm surge and river flood because of the synchronization of storm surge peaks and high river flow peaks, with a time difference of 1–2 h for small-and medium-sized rivers within 100 km2 of the basin.

Short term follow-up of femoral neck dynamic cross screw system and threaded cannulated screw in the treatment of vertically unstable femoral neck fractures

To analyze and compare the clinical effects of femoral neck dynamic cross screw system (FNS) and cannulated screws(CS) in the treatment of vertically unstable femoral neck fractures. The clinical data and short-term follow-up results of 40 patients with vertically unstable femoral neck fractures admitted from July 2020 to August 2021 were retrospectively analyzed. According to different internal fixation methods, 40 patients were divided into two groups, 20 cases in FNS group included 11 males and 9 females with a median of 58.5(50.3, 62.5) years old, and 20 in CS group included 9 males and 11 females with a median of 52.0(40.5, 58.0) years old. The operation time, knife edge length, blood loss and treatment cost of two gruops were observed and compared. The postoperative fracture healing and internal fixation were evaluated with X-ray imaging data, and the femoral neck shortening of the affected side was measured. The incidence of thigh irritation, the time of partial weight bearing and full weight bearing, early necrosis of femoral head, reoperation revision and Harris scores were compared between two groups. FNS group was followed up for 18.0(15.0, 19.0) months, CS group for 17.0(15.0, 18.8) months. There was no significant difference in operation time, incision length and blood loss between two groups(P>0.05). The cost of diagnosis and treatment in FNS group was higher than that in CS group(P<0.001). In FNS group, there was no irritation sign of the affected side thigh, while in CS group, there were 6 cases with discomfort or irritation sign of the lateral thigh(P<0.05). The average time of partial weight bearing activity in CS group was later than that in FNS group(P<0.05); However, there was no significant difference in the activity time of complete weight bearing between two groups(P=0.011>0.05). At the last follow-up, the shortened length of the affected femoral neck in CS group was greater than that in FNS group(P<0.05). There was no early necrosis of femoral head and reoperation in both groups. There was no significant difference in Harris score between two groups 12 months after operation(P>0.05). FNS treatment of vertically unstable femoral neck fractures can significantly reduce the incidence of lateral thigh irritation sign, and effectively reduce the postoperative shortening rate of vertically unstable femoral neck fractures, which can provide a relatively stable anti rotation force and anti cutting force, so that patients can go to the ground relatively early, which is conducive to the recovery of the affected hip joint function after surgery. It is a new option for the surgical treatment of vertically unstable femoral neck fractures. However, due to the high cost of treatment, In clinical practice, appropriate surgical treatment is selected according to the actual situation.

Application of superior iliac fascia block of inguinal ligament combined with patient controlled intravenous analgesia in elderly patients after hip arthroplasty

To compare the effect of patient-controlled intravenous analgesia(PCIA) and superior inguinal ligament iliac fascia block combined with PCIA after hip replacement in the elderly. Total of 82 elderly patients were treated with hip arthroplasty from June 2019 to June 2021 and randomly divided into observation group and control group. There were 42 patients in control group, including 18 males and 24 females, aged from 60 to 78 years old with an average of (70.43±3.67) years old, 28 femoral neck fractures and 14 femoral head necrosis, who received PCIA. The study group consisted of 42 cases, including 20 males and 22 females, aged from 61 to 76 years old with an average of (69.68±3.74) years old, 25 femoral neck fractures and 17 femoral head necrosis, who received superior inguinal ligament iliac fascia block combined with PCIA. Pain visual analogue scale (VAS) and Ramesay sedation scores at 2 h, 6 h, 12 h, 24 h and 48 h after operation were evaluated. In addition, the follow-up results of the total consumption of sufentanil and the total number of PCIA compressions at 48 hours after operation, the first time of landing after surgery, the time of hospital stay, the incidence of adverse reactions, the satisfaction with analgesia of two groups were observed. All patients were followed up for 9 to 24 months with an average of(13.85±2.67) months. There was no significant difference in operation time and intraoperative bleeding between two groups (P>0.05). There was no difference in VAS between two groups at 2 hours after operation (P>0.05), and the VAS of the study group at 6 h, 12 h, 24 h and 48 h after operation were lower than those of the control group(P<0.05). The Ramesay sedation scores of the study group at 2 h, 6 h and 12 h after operation were higher than those of the control group(P<0.05), and there were no differences in Ramesay score between two groups at 24 h and 48 h after operation (P>0.05). The consumption of sufentanil in the study group within 48 hours after operation was lower than that in the control group (P<0.05), and PCIA compression times were lower than those in the control group(P<0.05), and the time of first landing was earlier than that in the control group(P<0.05). There was no significant difference in hospital stay, adverse reaction rate, complications between two groups (P>0.05). The satisfaction of analgesia in the study group was higher than that in the control group (P<0.05). Superior iliac fascia block of inguinal ligament combined with PCIA has significant analgesic and sedative effects after hip arthroplasty in the elderly. It can reduce the amount of sufentanil used and the total number of PCIA compressions, which is conducive to the early activity of patients out of bed, improve the satisfaction of analgesia.

Application of metal cushion block combined with Jumbo cup in reconstruction of acetabular bone defect in revision of artificial hip joint

To investigate the application effect and imaging changes of metal cushion block combined with Jumbo cup in the reconstruction of acetabular bone defect after revision of artificial hip joint. Retrospective analysis was made on the clinical data of 83 patients who underwent revision acetabular bone defect reconstruction of the artificial hip joint in our hospital from September 2019 to October 2021. They were divided into group A and group B according to different surgical methods. There were 42 patients in group A, including 26 males and 16 females, aged from 44 to 72 years old with an average of (60.57±4.62) years, who underwent revision with metal cushion block and Jumbo cup. There were 41 patients in group B, including 22 males and 19 females, aged from 42 to 71 years old with an average of (58.74±4.25) years, who underwent revision with metal cushion block and bone cement mortar cup. The operation related indexes, Harris hip function score and visual analogue scale (VAS) of pain before operation, 1 month and 12 month after operation were compared between two groups. The results of X-ray imaging examination (hip rotation center height, acetabular abduction angle, femoral eccentricity and imaging standard qualification rate) before and 12 month after operation were evaluated, and the incidence of complications was compared between two groups. There was no significant difference in operation time, intraoperative bleeding volume and postoperative drainage volume between two groups (P>0.05). Both groups were followed up for 12 to 36 months with an average of (25.36±3.59) months. The scores of pain, function, deformity and Harris' total score in the two groups at 1 month after operation were higher than those before operation (P<0.05), and the scores of pain, function, deformity, joint activity and Harris' total score in two groups at 1 year after operation were higher than those before operation and 1 month after operation (P<0.05), and the above scores in group A were higher than those in group B at 1 year after operation (P<0.05). The VAS of two groups decreased successively at 1 month and 1 year after operation (P<0.05), but there was no significant difference in both groups at each time point (P>0.05). The femoral eccentricity increased in both groups at 1 year after operation (P<0.05), and group A was higher than group B (P<0.05). The height of rotation center and acetabular abduction angle decreased in both groups at 1 year after operation (P<0.05), and the height of rotation center in group A was lower than that in group B (P<0.05), but there was no significant difference in acetabular abduction angle between two groups (P>0.05). The imaging qualification rate of group A was higher than that of group B (P<0.05). There was no significant difference in the incidence of adverse reactions between two groups (P>0.05). Metal cushion block combined with Jumbo cup in the treatment of acetabular bone defects can provide the hip joint function, and restore the hip joint rotation center, femoral eccentricity and acetabular abduction angle, with obvious clinical effect.

Quantifying gadolinium-based nanoparticle uptake distributions in brain metastases via magnetic resonance imaging

AGuIX, a novel gadolinium-based nanoparticle, has been deployed in a pioneering double-blinded Phase II clinical trial aiming to assess its efficacy in enhancing radiotherapy for tumor treatment. This paper moves towards this goal by analyzing AGuIX uptake patterns in 23 patients. A phantom was designed to establish the relationship between AGuIX concentration and longitudinal (T1\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${T}_{1}$$\\end{document}) relaxation. A 3T MRI and MP2RAGE sequence were used to generate patient T1\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${T}_{1}$$\\end{document} maps. AGuIX uptake in tumors was determined based on longitudinal relaxivity. AGuIX (or placebo) was administered to 23 patients intravenously at 100 mg/kg 1–5 hours pre-imaging. Each of 129 brain metastases across 23 patients were captured in T1\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${T}_{1}$$\\end{document} maps and examined for AGuIX uptake and distribution. Inferred AGuIX recipients had average tumor uptakes between 0.012 and 0.17 mg/ml, with a mean of 0.055 mg/ml. Suspected placebo recipients appeared to have no appreciable uptake. Tumors presented with varying spatial AGuIX uptake distributions, suspected to be related to differences in accumulation time and patient-specific bioaccumulation factors. This research demonstrates AGuIX's ability to accumulate in brain metastases, with quantifiable uptake via T1\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${T}_{1}$$\\end{document} mapping. Future analyses will extend these methods to complete clinical trial data (~ 134 patients) to evaluate the potential relationship between nanoparticle uptake and possible tumor response following radiotherapy.Clinical Trial Registration Number: NCT04899908.Clinical Trial Registration Date: 25/05/2021.

Illuminating Snow Droughts: The Future of Western United States Snowpack in the SPEAR Large Ensemble

AbstractSeasonal snowpack in the Western United States (WUS) is vital for meeting summer hydrological demands, reducing the intensity and frequency of wildfires, and supporting snow‐tourism economies. While the frequency and severity of snow droughts (SD), that is, anomalously low snowpacks, are expected to increase under continued global warming, the uncertainty from internal climate variability remains challenging to quantify with observations alone. Using a 30‐member large ensemble from a state‐of‐the‐art global climate model, the Seamless System for Prediction and EArth System Research (SPEAR), and an observations‐based data set, we find WUS SD changes are already significant. By 2100, SPEAR projects SDs to be nearly 9 times more frequent under shared socioeconomic pathway 5‐8.5 (SSP5‐8.5) and 5 times more frequent under SSP2‐4.5, compared to a 1921–2011 average. By investigating the influence of the two primary drivers of SD, temperature and precipitation amount, we find the average WUS SD will become warmer and wetter. To assess how these changes affect future summer water availability, we track late winter and spring snowpack across WUS watersheds, finding differences in the onset time of a “no‐snow” threshold between regions and large internal variability within the ensemble that are both on the order of decades. We attribute the inter‐regional variability to differences in the regions' mean winter temperature and the intra‐regional variability to irreducible internal climate variability which is not well‐explained by temperature variations alone. Despite strong scenario forcing, internal climate variability will continue to drive variations in SD and no‐snow conditions through 2100.

Enamel surface roughness following debonding resin clean up using high speed air-turbine and electric handpieces. In vitro study

BackgroundHigh speed electric handpieces have recently been growing in popularity among dental professionals. Advantages include smoother surface preparation and increased cutting efficiency.AimThe primary objective was to compare enamel surface roughness following resin cleanup after bracket debonding using highspeed air turbine versus electric handpiece. The secondary objective was to record the time needed for resin-clean up.MethodForty deidentified freshly extracted human premolars were cleaned and sectioned at the cement-enamel junction. The crowns were embedded in acrylic blocks. Enamel surface roughness parameters (Ra, Rz, Rp and Rv) were measured using a stylus profilometer. Brackets were bonded using a light-cure orthodontic adhesive and stored in distilled water for 24 h. Following bracket debonding, the specimens were randomly divided into 2 groups: First group: resin clean-up was carried out using a 12-fluted carbide bur mounted on a high-speed air turbine; and second group: where an electric handpiece was used. Surface roughness parameters were measured following resin clean up and after polishing using pumice and a rubber cup. Time needed for resin clean-up was recorded. Differences in enamel surface roughness and time between groups were compared using repeated measures ANOVA and independent samples t-test, respectively at P ≤ 0.05.ResultsThe electric handpiece groups showed significantly higher values for Ra, Rz and Rp both following resin cleanup and polishing. Time taken for resin cleanup was significantly longer for the electric handpiece group.ConclusionConsidering both surface roughness and time, electric handpiece do not seem to add greater effectiveness or efficiency to resin cleanup following orthodontic bracket debonding.

Medial superior olive in the rat: Anatomy, sources of input and axonal projections

Although rats and mice are among the preferred animal models for investigating many characteristics of auditory function, they are rarely used to study an essential aspect of binaural hearing: the ability of animals to localize the sources of low-frequency sounds by detecting the interaural time difference (ITD), that is the difference in the time at which the sound arrives at each ear. In mammals, ITDs are mostly encoded in the medial superior olive (MSO), one of the main nuclei of the superior olivary complex (SOC). Because of their small heads and high frequency hearing range, rats and mice are often considered unable to use ITDs for sound localization. Moreover, their MSO is frequently viewed as too small or insignificant compared to that of mammals that use ITDs to localize sounds, including cats and gerbils. However, recent research has demonstrated remarkable similarities between most morphological and physiological features of mouse MSO neurons and those of MSO neurons of mammals that use ITDs. In this context, we have analyzed the structure and neural afferent and efferent connections of the rat MSO, which had never been studied by injecting neuroanatomical tracers into the nucleus.The rat MSO spans the SOC longitudinally. It is relatively small caudally, but grows rostrally into a well-developed column of stacked bipolar neurons. By placing small, precise injections of the bidirectional tracer biotinylated dextran amine (BDA) into the MSO, we show that this nucleus is innervated mainly by the most ventral and rostral spherical bushy cells of the anteroventral cochlear nucleus of both sides, and by the most ventrolateral principal neurons of the ipsilateral medial nucleus of the trapezoid body. The same experiments reveal that the MSO densely innervates the most dorsolateral region of the central nucleus of the inferior colliculus, the central region of the dorsal nucleus of the lateral lemniscus, and the most lateral region of the intermediate nucleus of the lateral lemniscus of its own side. Therefore, the MSO is selectively innervated by, and sends projections to, neurons that process low-frequency sounds. The structural and hodological features of the rat MSO are notably similar to those of the MSO of cats and gerbils. While these similarities raise the question of what functions other than ITD coding the MSO performs, they also suggest that the rat MSO is an appropriate model for future MSO-centered research.

Minorities Face Delays to Pancreatic Cancer Treatment Regardless of Diagnosis Setting.

Our analysis was designed to characterize the demographics and disparities between the diagnosis of pancreas cancer during emergency presentation (EP) and the outpatient setting (OP) and to see the impact of our institutions pancreatic multidisciplinary clinic (PMDC) on these disparities. Institutional review board-approved retrospective review of our institutional cancer registry and PMDC databases identified patients diagnosed/treated for pancreatic ductal adenocarcinoma between 2014 and 2022. Chi-square tests were used for categorical variables, and one-way ANOVA with a Bonferroni correction was used for continuous variables. Statistical significance was set at p < 0.05. A total of 286 patients met inclusion criteria. Eighty-nine patients (31.1%) were underrepresented minorities (URM). Fifty-seven (64.0%) URMs presented during an EP versus 100 (50.8%) non-URMs (p = 0.037). Forty-one (46.1%) URMs were reviewed at PMDC versus 71 (36.0%) non-URMs (p = 0.10). No differences in clinical and pathologic stage between the cohorts (p = 0.28) were present. URMs took 22 days longer on average to receive treatment (66.5 days vs. 44.8 days, p = 0.003) in the EP cohort and 18 days longer in OP cohort (58.0 days vs. 40.5 days, p < 0.001) compared with non-URMs. Pancreatic Multidisciplinary Clinic enrollment in EP cohort eliminated the difference in time to treatment between cohorts (48.3 days vs. 37.0 days; p = 0.151). Underrepresented minorities were more likely to be diagnosed via EP and showed delayed times to treatment compared with non-URM counterparts. Our PMDC alleviated some of these observed disparities. Future studies are required to elucidate the specific factors that resulted in these findings and to identify solutions.

B.2 Time from symptom onset and number of health care encounters prior to diagnosis of cerebral venous thrombosis

Background: Cerebral venous thrombosis (CVT)most commonly affects younger women. Diagnosis may be delayed due to its distinct presentation and demographic profile compared to other stroke types. Methods: We examined delays to diagnosis of CVT in the SECRET randomized trial and TOP-SECRET parallel registry. Adults diagnosed with symptomatic CVT within &lt;14 days were included. We examined time to diagnosis and number of health care encounters prior to diagnosis and associations with demographics, clinical and radiologic features and functional and patient-reported outcomes (PROMS) at days 180&amp;365. Results: Of 103 participants, 68.9% were female; median age was 45 (IQR 31.0-61.0). Median time from symptom onset to diagnosis was 4 (1-8) days. Diagnosis on first presentation to medical attention was made in 60.2%. The difference in time to diagnosis for single versus multiple presentations was on the order of days (3[1-7] vs. 5[2-11.75], p=0.16). Women were likelier to have multiple presentations (OR 2.53; 95% CI1.00-6.39; p=0.05) and longer median times to diagnosis (5[2-8]days vs. 2[1-4.5] days; p=0.005). However, this was not associated with absolute or change in functional, or any patient reported, outcome measures (PROMs) at days 180&amp;365. Conclusions: Diagnosis of CVT was commonly delayed; women were likelier to have multiple presentations. We found no association between delayed diagnosis and outcomes.

Identification of reentry vulnerable targets during substrate mapping for ablation in scar related VT: the "visual" reentry vulnerability index

Abstract Introduction Conduction abnormalities including zones of deceleration (DZ) &amp; late activation are functionally important targets for ablation in scar-related ventricular tachycardias (VT). Repolarisation heterogeneities are equally important but are not routinely assessed. Visualisation of a combination of both conduction &amp; repolarisation metrics whilst in sinus in the form of a re-entry vulnerability index (RVI) may enable more precise identification of critical ablation targets. Rationale: To test accuracy of a novel functional substrate mapping strategy combining conduction &amp; repolarisation metrics to "visually" estimate reentry vulnerability sites (RVIv) during scar related VT ablation without the need for offline processing required for "computational" RVI. Methods VT cases using a multipolar grid-catheter for contact mapping were reviewed. DZ &amp;areas of late activation were tagged on omnipolar LAT substrate maps. The corresponding unipolar repolarisation maps depicting local repolarisation time (LRT) based on the Wyatt method (WOI over T-Wave annotating to +dV/dt, UEGM-Filter 0.05-100Hz) were then displayed side-by-side with the LAT map. Timing reference was set to onset of surface QRS. Colour scale of LRT maps was set to start at or ahead of the timing of latest LAT. "Visual RVI" zones were identified if the tagged zone of late activation was overlapping and/or directly adjacent to an area of "early" repolarisation (defined as before or within 100ms of latest LAT point) based on colour. In visually identified RVI areas, temporal (timing difference in ms) &amp; spatial relationship (distance in mm) of EGMs with earliest RT (RTe) to EGM with latest AT (ATL) separated by max. 20mm were measured &amp; RVI calculated (RTe subtracted by ATL). Number of RVIv zones per map, RVI metrics &amp; distance from closest RVI to VT Exit site (defined per activation±entrainment or pace mapping) were assessed. The lower/negative the numeric RVI, the higher the vulnerability for reentry. Results 20 patients with scar-related reentry VT were included (90% male, 63.8±11.6 years, LVEF 36±16%, 60% ischemic/40% non-ischemic). LAT &amp; LRT map point counts were 4835±2625 and 3596±2805. In 17 (85%) patients at least 1 RVIv zone was identified, with on avg. 3.3±1.7 RVIv zones/patient. Manual RVIs were calculated to 10.4±78.9ms ( "most vulnerable" RVI was -227ms) with on avg. 9.5±5.3mm distance between RTe &amp; ATL. All maps with no RVIv zone on the mapped surface were of non-ischemic etiology. The shortest distance of RVIs to functionally critical sites during VT was 8.9±7.4mm (range 0-33mm). Conclusion Visual reentry vulnerability estimation based on a combination of established conduction and novel repolarisation maps is feasible &amp; may help to identify functionally critical zones during substrate mapping. Future efforts should include dedicated automated repolarisation mapping tools to facilitate integration of repolarisation dynamics in functional VT substrate mapping workflows.Figure 1Example Visual RVI Mapping

Conduction system pacing preserves both electrical and mechanical interventricular synchrony, a UHF ECG validation study

Abstract Background Interventricular mechanical delay (IVMD) is an established echocardiographic risk factor for pacing-induced cardiomyopathy development. Ultra-high-frequency ECG (UHF-ECG) is a non-invasive tool visualizing the ventricular activation sequence. Purpose To compare UHF-ECG interventricular dyssynchrony with echocardiography and to establish interventricular dyssynchrony related to conductive system pacing (CSP) and right ventricular myocardial pacing (RVP). Methods 53 patients with advanced AV conduction disease, without organic heart disease, and preserved LV systolic function were prospectively included. Thirty-two had RVP, and twenty-one had CSP. CSP included both His bundle pacing (n=5) and left bundle branch area pacing (n=16). UHF-ECG and echocardiography were obtained at the baseline (during spontaneous rhythm) and after 1 year (during pacing). IVMD was manually calculated as a difference between the time from a distinct point of the QRS until the onset of the flow through LV and RV outflow tract using pulsed wave doppler imaging. Analysis was performed by two experienced and blinded cardiologists. Interventricular e-DYS was calculated automatically by a software as a time difference between activation in V8 (LV free wall) and V1 electrode (RV free wall). Results The average age of all included patients was 76 ± 6 years old and patients in both RVP and CSP group had similar clinical characteristics. The values of IVMD and interventricular e-DYS were similar in the whole study population both before the pacemaker implantation (-2 ± 21 ms for IVMD vs. 0 ± 20 ms for interventricular e-DYS; p=0.31) and after one year (14 ± 23 ms for IVMD vs. 14 ± 24 ms for UHF; p = 0.7). There were no significant differences in the baseline IVMD and interventricular e-DYS between those receiving CSP vs. RVP (IVMD -6 ± 22 ms for CSP vs 2 ± 20 ms for RVP, p=0.22) and interventricular e-DYS (e-DYS -5 ± 20 ms for CSP vs. 3 ± 20 ms for RVP, p=0.34). After one year of pacing, the patients with CSP preserved similar levels of both IVMD (mean change -2 ± 5 ms, p=0.74) and interventricular e-DYS V8-V1 (mean change 0 ± 4 ms, p = 0.95) – Figure 1. There was no difference between IVMD and interventricular e-DYS in CSP patients after one year (p=0.92). On the contrary, in the RVP group IVMD increased for 27 ± 5 ms (p &amp;lt;0.0001) and interventricular e-DYS for 24 ± 5 ms (p &amp;lt;0.0001) compared to the baseline - Figure 1. There was no difference between IVMD and interventricular e-DYS in RVP patients after one year (p=0.75). There was a moderate overall correlation between IVMD and e-DYS V8-V1 in all studied ventricular rhythms (R=0.73, p&amp;lt;0.0001) – Figure 2. Conclusions UHF-ECG expresses the interventricular dyssynchrony noninvasively by measuring the activation difference between V8-V1 chest leads. RV myocardial pacing increases interventricular dyssynchrony, while CSP preserves synchronous ventricular activation.CSP vs RVPcorrelation of dyssynchrony

Leadless pacemaker implantation versus conventional transvenous cardiac pacing early after transcatheter aortic valve replacement: a safe and relevant option?

Abstract Background Leadless pacemakers (LPM) are known to have lower postoperative complications than conventional transvenous cardiac pacing especially in frail patients (pts) with many comorbidities. The aim of this study was to assess the "real-life" feasibility and outcomes of LPMs compared to transvenous pacemakers (TPMs) in patients who underwent transcatheter aortic valve replacement (TAVR). Methods This is a retrospective single center study including all consecutive patients who received LPM or TPM (either single or double chamber) implantation early after a TAVR over a one-year period since September 2022 with a follow up period of at least 3 months. Results 71 pts were included (mean age 82,56 ± 7,1 years old). 16 pts underwent LPM implantation (22,5%). Leadless system pacing was preferred in pts with history of active systemic infection 43,8%, complex conventional vascular approach 12,5 %, deterioration of general condition and clinical frailty 18,8% and history of breast cancer in 25 % pts. Mean time between appearance of conductive disorders and pacemaker implantation was longer (2,9± 2,8 vs 1,5 ± 1,3 days; p=0,06) in the LPM group probably due to organizational issues. Procedure duration was significantly shorter in the LPM group (46 ±20,5 vs 69 ± 21,1 min; p = 0,01). There was no statistically significant difference in fluoroscopy time between the 2 groups even though this parameter was longer in the LPM group (6,8 min vs 5,6 min; p = 0,413). Significantly lower thresholds were observed in pts with LPM implantation (0,45 ± 0,33 vs 0,66 ± 0,25 V; p = 0,017) with no statistically significant difference between the 2 groups concerning the per-operative impedance value. Median time from pacemaker implantation to discharge was 3,12 ± 3,26 vs 4,78 ±7,16 days after LPM and TPM implantation respectively (p = 0,195). There were less complications in the LPM group (1,4 % vs 9,9 %; p = 0,471). Complications were: arteriovenous fistula for 1 pt with LPM vs 2 pocket hematomas, 1 pneumothorax, 1 per-operative cardiac arrest and 3 leads dislodgements in pts with TPM. The mortality rate was significantly higher in the LPM group (4,2 % vs 2,8 %; p = 0,038) although no pacemaker related deaths were reported in both groups and no significant difference between the 2 groups was noted concerning rehospitalisations for cardiovascular cause (p= 0,407). Conclusion Early LPM implantation after TAVR is a feasible alternative to conventional pacing with significantly shorter procedure durations and better pacing thresholds. Our experience confirms the global clinical frailty of patients receiving LPM after TAVR but underlines the favorable safety profile of leadless system pacing with a low rate of complications.

P.086 The effect of after-hours surgical resection on the outcomes in patients with high grade gliomas

Background: The “weekend effect” is the finding that patients presenting for medical care outside of regular working hours tend to have worse outcomes. There is a paucity of literature in the neuro-oncology space exploring this effect. We investigated the extent of resection and complication rates in patients undergoing after-hours high grade glioma resection. Methods: A retrospective review was conducted on patients with high-grade gliomas requiring emergent surgery between January 2021 to March 2023. After-hours was defined as surgical resection on the weekend and/or evening. These patients were matched to patients undergoing resection during regular working hours. Results: A total of 38 patients were included in this study (19 after-hours, 19 regular hours). There was no significant difference in age, sex, tumor grade, and tumor size between the two groups (all p&gt;0.05). There was no significant difference in the extent of resection between the groups (p=0.7442). There was no significant difference in complications rates, reoperation rates, and death at 6 months (all p&gt;0.05). Estimated blood loss was significantly higher in the regular hours group (p=0.0278). There was no significant difference in the total operative time (p=0.0643) and length of stay (p=0.0601). Conclusions: After-hours high grade glioma surgery is not associated with increased morbidity or mortality.