LA Group Research Articles

Laparoscopic versus open appendectomy in the management of chronic appendicitis

Background The term ‘chronic appendicitis’ (CA) is still clearly undefined. However, once established, it necessitates appendectomy, which could be performed via open or laparoscopic approaches. Comparisons between the two approaches have been made in acute appendicitis cases, with no previous trials including CA patients. That is why we conducted this study to compare these two approaches in the management of CA patients. Methodology 50 CA were included in our prospective trial, and they were randomly assigned into two groups; the OA group (25 open appendectomy patients) and the LA group (25 laparoscopic appendectomy cases). Results The statistical analysis revealed no significant differences between the two groups regarding most preoperative characteristics. The laparoscopic approach was associated with significant prolongation in operative time that had an average of 1 h in the LA group, while it ranged between 0.5 and 1 h in the OA group (P = 0.005). Nonetheless, laparoscopy led to a significantly better postoperative recovery profile, manifested in the shorter hospitalization period (1 vs. 2 days in the open approach) and less postoperative pain (all patients with mild pain compared with moderate pain in the open group). Only 2 (8%) casesexperienced temporary vomiting in the OA group. Conclusion Laparoscopy is superior to the open approach in the management of chronic appendicitis patients. It is associated with a better analgesic profile, a shorter hospitalization period, and a better chance of detecting other concomitant intraabdominal pathologies. However, the increased operative time should be considered.

Construction of Lanthanide Magnetic Bio-Based Porous Carbon Materials with Beam and Column Structure and Its Synergistic Adsorption Performance.

Biochar porous carbon material (BPCM) has extraordinary adsorption properties and is being widely used in different fields around the world. The pore structure of BPCM is liable to collapse, and mechanical properties are inferior; hence, the focus is on developing a new ″powerful″ structure of functional BPCM. Rare earth elements with characteristic f orbitals are used as pore and wall strengthening units in this work. The new ″beam and column structure″ BPCM was synthesized by the aerothermal method, and then, the magnetic BPCM was prepared. The results showed that the designed synthesis route was reasonable, BPCM with a steady-state beam and column structure was attained, and the La element played a stabilizing role in maintaining the overall BPCM. The La hybridization exhibits the characteristic of ″the stronger column and weaker beam″, and the La group is the ″column″ to strengthen the BPCM as the ″beam″. The functionalized BPCM (lanthanum-loaded magnetic chitosan-based porous carbon materials, MCPCM@La2O2CO3) obtained exhibited a transcendent efficient adsorption capacity with an average adsorption rate of 6.640 mg·g-1·min-1 and over 85% removal of different types of dye pollutants, which exceeded the adsorption performance of the materials of most other BPCMs. Ultrastructural analysis revealed that MCPCM@La2O2CO3 has a huge specific surface area of 1458.513 m2·g-1 and a magnetization value of 16.560 emu·g-1 for MCPCM@La2O2CO3. A new theoretical model for the adsorption of MCPCM@La2O2CO3 (multiple adsorption coexistence equation) was established. The theoretical equations clarify that the mechanism of pollutant removal by MCPCM@La2O2CO3 is different from the traditional adsorption model, presenting a mechanism of coexistence of multiple adsorption types, displaying a monolayer-multilayer adsorption mechanism, influenced by the synergistic effects of H bonding, electrostatic attraction, π-π conjugation, and ligand interaction. The rapid coordination of the d orbitals of La is an obvious factor in enhancing the adsorption efficiency.

Relationship among seminal antigenicity, antioxidant status and metabolically active sperm from Holstein-Friesian (Bos taurus) bulls

Sperm antigenicity has been implicated as a regulatory factor for acquiring fertilizing competence in the female reproductive tract. Overt immune response against the sperm proteins leads to idiopathic infertility. Hence, the aim of the study was to evaluate the influence of the auto-antigenic potential of sperm on the antioxidant status, metabolic activities and reactive oxygen species (ROS) in bovine. Semen from Holstein-Friesian bulls (n = 15) was collected and classified into higher (HA, n = 8) and lower (LA, n = 7) antigenic groups based on micro-titer agglutination assay. The neat semen was subjected to the evaluation of bacterial load, leukocyte count, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and lipid peroxidation (LPO) levels. Antioxidant activities in seminal plasma and intracellular ROS levels in the post-thawed sperm were estimated. The number of leukocytes was lower (p < .05) in the HA than the LA semen. The percentage of metabolically active sperm was higher (p < .05) in HA than the LA group. The activities of total non-enzymatic antioxidant, superoxide dismutase (SOD) and catalase (CAT) were higher (p < .05) while glutathione peroxidase activity was lower (p < .05) in the seminal plasma of LA group. The LPO levels of neat sperm and the percentage sperm positive for intracellular ROS in the cryopreserved sample were lower (p < .05) in the HA group. Auto-antigenic levels were positively correlated with the percentage of metabolically active sperm (r = 0.73, p < .01). However, the seminal auto-antigenicity was negatively (p < .05) correlated with the levels of SOD (r=–0.66), CAT (r=–0.72), LPO (r=–0.602) and intracellular ROS (r=–0.835). The findings were represented in graphical abstract. It is inferred that the higher auto-antigenic levels protect the quality of bovine semen by promoting sperm metabolism and lowering ROS and LPO levels.

SUCCOR Nodes: May Sentinel Node Biopsy Determine the Need for Adjuvant Treatment?

BackgroundThe SUCCOR cohort was developed to analyse the overall and disease-free survival at 5 years in women with FIGO 2009 stage IB1 cervical cancer. The aim of this study was to compare the use of adjuvant therapy in these women, depending on the method used to diagnose lymphatic node metastasis.Patients and MethodsWe used data from the SUCCOR cohort, which collected information from 1049 women with FIGO 2009 stage IB1 cervical cancer who were operated on between January 2013 and December 2014 in Europe. We calculated the adjusted proportion of women who received adjuvant therapy depending on the lymph node diagnosis method and compared disease free and overall survival using Cox proportional-hazards regression models. Inverse probability weighting was used to adjust for baseline potential confounders.ResultsThe adjusted proportion of women who received adjuvant therapy was 33.8% in the sentinel node biopsy + lymphadenectomy (SNB+LA) group and 44.7% in the LA group (p = 0.02), although the proportion of positive nodal status was similar (p = 0.30). That difference was greater in women with negative nodal status and positive Sedlis criteria (difference 31.2%, p = 0.01). Here, those who underwent a SNB+LA had an increased risk of relapse [hazard ratio (HR) 2.49, 95% confidence interval (CI) 0.98–6.33, p = 0.056] and risk of death (HR 3.49, 95% CI 1.04–11.7, p = 0.042) compared with those who underwent LA.ConclusionsWomen in this study were less likely to receive adjuvant therapy if their nodal invasion was determined using SNB+LA compared with LA. These results suggest a lack of therapeutic measures available when a negative result is obtained by SNB+LA, which may have an impact on the risk of recurrence and survival.

Gender differences in professional social networks use among critical care researchers

BackgroundRecent studies highlight that female anaesthesiology researchers have lower visibility on professional social networks (PSNs) than male researchers. ObjectiveThe objective of this work was to compare the use of PSNs between women and men in critical care research. MethodsWe included the first/last authors (FAs/LAs) among the most frequently cited articles in 2018 and 2019 in three critical care journals (Intensive Care Medicine, Critical Care Medicine, and Critical Care). We compared the use of three PSNs—Twitter, ResearchGate, and LinkedIn—between women and men in the FA/LA positions. ResultsWe analysed 494 articles, which allowed us to include 426 FAs and 383 LAs. The use of a PSN was similar between women and men (Twitter: 35 vs. 31% FA p = 0.76, 38 vs. 31% LA p = 0.24; ResearchGate: 60 vs. 70% FA p = 0.06, 67 vs. 66% LA p = 0.95; LinkedIn: 54 vs. 56% FA p = 0.25, 68 vs. 64% LA p = 0.58; respectively). On ResearchGate, women had a lower reputation score (FA group 26.4 [19.5–31.5] vs. 34.8 [27.4–41.6], p < 0.01; LA group 38.5 [30.9–43.7] vs. 42.3 [37.6–46.4], p < 0.01) and fewer followers (FA group 28.5 [19–45] vs. 68.5 [72,5–657] p < 0.01; LA group 96.5 [43,8–258] vs. 178 [76.3–313.5] p = 0.02). Female researchers were FAs in 30% of the articles and LAs in 16%. ConclusionIn the field of critical care, the visibility of female researchers on the social networks dedicated to scientific research is lower than that of male researchers.

A Simple Technique of Tunnel Constructing for Occluding Splenic Vessels During Laparoscopic Splenectomy in Patients with Cirrhosis.

Purpose: Dissecting and ligating the splenic artery is crucial for bleeding control during laparoscopic splenectomy (LS). However, for patients with portal hypertension from liver cirrhosis, it is difficult for identification and ligation because the splenic vessel is circuitous and dilated. The aim of this study was to describe a simple technique of constructing a tunnel behind the tail of the pancreas for occluding the splenic vessels during LS in patients with portal hypertension. Materials and Methods: The clinical data of 61 patients who underwent LS from April 2016 to January 2017 were retrospectively analyzed. In 27 patients, the tunnel construction (TC) behind the tail of the pancreas approach was performed owning to difficulty in dissecting and ligating the splenic artery (TC group), including 17 patients who received the TC method directly and 10 patients who received the TC method after trying to dissect the splenic artery. The remaining 34 patients underwent traditional ligating of the splenic artery (LA group). The peri- and postoperative outcomes of operative time, blood loss, conversion rate, postoperative oral diet intake, postoperative hospital stay, and postoperative complication rate of the two groups were analyzed. All the operations were completed by the same group of surgeons. Results: All 61 operations were successfully completed. Compared with patients in the LA group, patients in the TC group had less blood loss (120.37 ± 40.74 mL versus 162.65 ± 87.47 mL; t = -2.317, P = .024). There was no statistical difference of operative time, conversion rate, complication rate, postoperative hospital stays, and follow-up between the two groups. Conclusions: The technique of constructing a tunnel behind the tail of the pancreas for occluding the splenic vessels was effective and safe in those patients whose splenic artery was difficult to dissect and ligate.

Ammonia Stress Disturbs Moult Signaling in Juvenile Swimming Crab Portunus trituberculatus

Ammonia is a significant concern during hatchery culture in brachyuran species, and its accumulation may lead to abortive moulting and large-scale deaths of the early juveniles. To date, the underlying mechanism for ammonia-induced alteration of the moulting process is still unknown. In this study, we aimed to investigate the effects of ammonia on the moulting as well as the potential mechanisms in early juveniles of the swimming crab Portunus trituberculatus, an important aquaculture species in China. We evaluated the survival rate and moulting rate of the juvenile crabs (C2) and analyzed the expression pattern of the genes in key components of molt signaling during a complete moulting cycle under different concentrations of ammonia nitrogen (the control group: <0.1 mg/L; the LA group: 5 mg/L; and the HA group: 20 mg/L). The results showed that: (1) the survival rate in the LA and HA groups was lower than that in the control group at the end of the experiment, and moulting death syndrome (MDS) was only observed in the HA group; (2) the moulting rate was higher in the LA group and lower in the HA group compared to the control group; (3) consistent with the results of the moulting experiment, MIH showed decreased expression, and genes related to ecdysteroid synthesis, ecdysteroid receptors, and responsive effectors exhibited increased expression in the LA group compared to the control group; and (4) although MIH expression was upregulated, increased expression of the genes associated with ecdysteroid synthesis, ecdysteroid receptors and downstream effectors still observed in the HA group. Our results indicated that low levels of ammonia can promote moulting in juvenile swimming crabs by inhibiting the expression of MIH and activating moult signaling, whereas high levels of ammonia inhibit moulting and lead to MDS through impairing moult signaling.

Changes in aberrations and biomechanics after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) in eyes with high astigmatism: a retrospective case control study

Background:To compare the 6-month changes in aberration and biomechanics after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for high astigmatism.Methods:In this retrospective case control study, 47 eyes with high astigmatism (≥ 2.5 D, HA group) and 47 eyes with low astigmatism (≤ 1.0 D, LA group) underwent FS-LASIK. Preoperative and follow-up examinations included visual outcomes, higher order aberrations (HOAs) and biomechanics. Biomechanical parameters include a deformation amplitude ratio of 2 mm (DA ratio 2 mm), integrated inverse radius (IIR), stiffness parameter at first applanation (SP-A1), and ambrosio relational thickness through the horizontal meridian (ARTh).Results:Six months postoperatively, there was no significant difference in the efficacy and safety index (both P > 0.05) between the two groups, but the cylinder was higher in the HA group. The HOAs increased significantly after surgery in both groups (all P < 0.05). Six months postoperatively, the changes in spherical aberration and HOAs were larger in the HA group (both P < 0.005), but there was no significant difference between the changes in coma (P > 0.05). Significant decreases in SP-A1 and ARTh and significant increases in the IIR and DA ratio of 2 mm (all P < 0.05) were observed after surgery in both groups. The changes in the DA ratio 2 mm, IIR, SP-A1, and ARTh were not significantly different between the groups.Conclusion:FS-LASIK had relative comparable efficacy and safety in correcting high and low myopic astigmatism, with higher astigmatic under-correction in eyes with high astigmatism. High astigmatism in eyes after FS-LASIK could introduce larger corneal aberrations, but the impact on corneal stiffness was the same as that in eyes with low astigmatism.

Outcomes of Open Bankart Repair Plus Inferior Capsular Shift Compared with Latarjet Procedure in Contact Athletes with Recurrent Anterior Shoulder Instability.

Open Bankart repair plus inferior capsular shift (OBICS) and Latarjet procedure (LA) are considered appropriate treatment alternatives for high-performance athletes. The purpose of this study was to evaluate the functional outcomes and recurrence rate of each surgery. Our hypothesis: there were no differences between the two treatments. A prospective cohort study was conducted with n=90 contact athletes divided into two groups of 45 patients. One group was treated with OBICS, and the other one with LA. The mean follow-up period was 25 (24-32) months for the OBICS group and 26 (24-31) months for the LA group. Primary functional outcomes of each group were assessed at baseline, six months, one year, and two years after surgery. The functional outcomes were also compared between the groups. The evaluation tools used were the Western Ontario Shoulder Instability score (WOSI) and the American Shoulder and Elbow Surgeons scale (ASES). In addition, recurrent instability and range of motion (ROM) were also evaluated. In each group, significant changes were found in the WOSI score and ASES scale from pre-op to postop. However, there were no significant differences between the functional outcomes of the groups at the final follow-up (P-values 0.73 and 0.19). Three dislocations and one subluxation (8.8%) were reported in the OBICS group, and three subluxations were reported in the LA group (6.6%), revealing no significant differences between the groups (P=0.37). Moreover, there were no significant differences between preoperative and postoperative ROM in each group or in terms of external rotation (ER) and ER in 90º abduction between the groups. No differences were found between OBICS and LA surgery. Both procedures can be indicated according to the surgeon's preference to reduce recurrence rates in contact athletes with recurrent anterior shoulder instability.

발달장애 초등학생의 AAC 상징 이해 정확도 및 선호도

Background and Objectives: Children with Complex Communication Needs(CCN) can use Augmentative and Alternative Communication(AAC) to support their communication. AAC systems include graphic symbols and it is important that they are comprehensible by these children. DAS (Developmentally Appropriate Symbols) were developed for the children, but there is very limited evidence on comprehension and preference of this symbol set by children with developmental disabilities. Therefore, this study aimed to investigate comprehension and preference of AAC graphic symbols including DAS, Ewha-AAC symbols, and wetok. Method: Ten elementary school students with developmental disabilities(DD group) and 10 children without disabilities (language age matching: LA group) participated in this study. Seven abstract words (Eat, come, big, none, who, what, up) were selected and different AAC symbol sets(DAS, Ewha-AAC symbols, wetok) for these words were presented to the participants. After an instruction session on the meanings of the symbols, their comprehension and preference data were collected. Results: The results showed significant differences between the participant groups with higher accuracy from children without disabilities. The results also revealed that most of the DD group preferred DAS, while most of the other group preferred wetok. Conclusion: From the results of this study, it is suggested that comprehension and preference for DAS, Ewha-AAC symbols, and wetok were different in children with/without developmental disabilities. Therefore, it is recommended that AAC symbol design and selection should be based on children’s characteristics and profile, particularly for children with developmental disabilities.

General vs Local Anesthesia for Percutaneous Endoscopic Lumbar Discectomy (PELD): A Systematic Review and Meta-Analysis.

Systematic review. It remains unknown whether general anesthesia (GA) or local ± epidural anesthesia (LA) results in superior outcomes with percutaneous endoscopic lumbar discectomy (PELD). The present study sought to examine the impact of anesthesia type on patient-reported outcomes (PROs) and complications with PELD. Systematic review and meta-analysis examining PELD performed under GA or LA was conducted. Patient-reported outcomes including Visual Analog Scale (VAS)-leg/back, and Oswestry Disability Index (ODI) scores were collected. Complication, recurrent disc herniation, durotomy, and reoperation rates as well as surgical data were recorded. All outcomes were compared between pooled studies examining GA or LA. Sixty-eight studies consisting of 5269 patients (724GA, 4465 LA) were included in the meta-analysis. Overall complication rate was significantly higher in the GA group (9% vs 4%, P = .003). Durotomy rates, length of stay, recurrent disc herniation and reoperation rates were similar between groups. At the first follow-up timepoint, the LA group demonstrated significant improvements in VAS back and ODI scores (P < .05) while the GA group did not (P > .05). At the final follow-up (> 6months), the percent of patients achieving an excellent McNab score was significantly higher in the GA vs LA group (P < .001). Percutaneous endoscopic lumbar discectomy with LA may be associated with greater short-term improvement in VAS back pain and ODI scores. General anesthesia may be associated with more durable pain relief but a higher complication rate. Further systematic investigation is necessary to determine what short and long term benefits are associated with PELD performed under LA and GA.

706: OUTCOME COMPARISON OF INHALED ANESTHETICS VERSUS ECMO IN CHILDREN WITH NEAR-FATAL ASTHMA

Introduction: Extracorporeal Membrane Oxygenation (ECMO) and Inhaled Anesthetics (IA) are considered in the management of Near-Fatal Asthma (NFA) refractory to conventional therapy. We sought to compare these two modalities in children. Methods: This is a retrospective study using the Virtual Pediatric Systems Database, (VPS, LLC). We included patients < 18 years of age with NFA treated with IA and/or ECMO between January 2010 and December 2020. Primary outcome was survival to hospital discharge. Results: A total of 221 patients were included in the study; 149 (67%) received only ECMO, 62 (28%) received only IA and 10 (5%) patients received both. There was no difference in age, PIM3, PRISM3, PELOD scores, pre-intervention pH or pCO2 between the ECMO and lA groups. The ECMO group had lower pre-intervention PaO2 (60 vs 78mmHg, p < 0.001) and higher utilization of high frequency oscillatory ventilation compared to the IA cohort. Pre intervention heliox was used more frequently in the lA group (p < 0.001). There was no difference in survival to hospital discharge; 128/149 (86%) in ECMO and 57/62 (92%) in IA (p=0.38) cohorts. The ECMO group had longer duration of intervention (5 vs 1.3 days, p< 0.001), more frequent mid intervention cardiac arrest (7% vs 2%, p= 0.04), longer ICU length of stay (LOS) (13 vs 7 days p< 0.001) and required more bronchoscopies (34% vs 11% p< 0.001). Post-intervention mechanical ventilation was similar among survivors (p=0.38). Conclusions: In our study, ECMO and IA had comparable survival to hospital discharge. However, ECMO was associated with higher risk of complications and ICU LOS.

Lateral or Medial Parapatellar Surgical Approach to the Valgus Osteoarthritic Knee? A Retrospective Single-Center Study.

Aims: Total knee arthroplasty in patients with fixed valgus deformity is a demanding procedure. The aim of this study was to compare the clinical results of using the lateral approach [LA] versus the medial approach [MA] in the treatment of fixed valgus knee deformities. Methods: This single-center study compared the results of 143 consecutive patients with fixed valgus deformity (mean 21.55° valgus, mean age 68.2 years) undergoing LA Total Knee Arthroplasty [TKA] to 50 patients (mean 16.58° valgus, mean age 67.2 years) undergoing MA TKA. The mean follow-up period was 5.1 years (2–10 years). Data was collected from operative notes, routine postoperative visits, and radiological findings. Apart from a radiological evaluation, patients were clinically assessed both pre- and postoperatively using the Knee Society Score [KSS]. Descriptive statistics together with the Kolmogorov-Smirnov test, the Student’s t-test for independent samples, and the Mann-Whitney U test were used. The level of significance in this study was α = 0.05. Results: In the LA group, the KSS Knee was significantly higher than in the MA group [85.31 vs. 77.42, respectively, p-value < 0.001]. The difference was also in the KSS total but with no statistical significance [155.17 vs. 149.22, p-value 0.087]. The surgery time in the LA group was shorter than in the MA group [81 vs. 91 min, respectively, p-value—0.002]. The complication rate after surgery was higher in the MA group than in the LA group (14% vs. 9%, respectively). Conclusions: The lateral approach is a good alternative to the standard medial parapatellar approach in the treatment of fixed valgus knee deformities. A higher postoperative KSS Knee, shorter surgery time, and similar complication rate make the lateral approach a valuable option for treating patients with osteoarthritis and fixed valgus knee deformity.

Ultrasound-guided serratus anterior block versus instillation of local anaesthetic through surgical drain in modified radical mastectomy: A randomized controlled study

ABSTRACT Background The primary outcome measure of this study was to compare ultrasound-guided serratus anterior block versus instillation of local anesthetic through the surgical drain in modified radical mastectomy patients as regards the duration of analgesia between the two techniques. Material and methods This prospective, randomized, double-blinded study was conducted on 162 female patients aged 25–50 years, ASA 1, ASA 2, selected for elective unilateral modified radical mastectomy in the Main University Hospital. Group SABP (n = 81) received 20 ml bupivacaine 0.5% in the plan between serratus anterior and latissimus dorsi muscles. Group LA (n = 81) received 40 ml bupivacaine 0.25%, 20 ml in each surgical drain (axillary and chest wall drain). Results The results of the study revealed that the duration of analgesia lasted for 20.8 hr in the SAPB group, while it was 8.14 hourshr in the LA group (P-value ˂0.001). In most postoperative periods, the SAPB group had lower VAS scores at rest and with movement of the ipsilateral arm compared to the LA group. The overall dose and frequency of the consumed rescue analgesic over the first 24 hr in the postoperative period were significantly lower in the SAPB group than in the second group (P-value <0.001). The SAPB group had higher satisfaction scores than the LA group (P-value <0.001). Conclusion It was concluded that the SAPB technique showed superiority over the anesthetic instillation method in controlling acute post-mastectomy pain with a longer duration of analgesia, more patient satisfaction, and less rescue analgesics were consumed.

Effect of Dietary Linoleic Acid (18:2n-6) Supplementation on the Growth Performance, Fatty Acid Profile, and Lipid Metabolism Enzyme Activities of Coho Salmon (Oncorhynchus kisutch) Alevins.

Simple SummaryIn China, coho salmon is becoming an increasing farming species in recent years. Thus, full understanding of the fatty acid requirements of coho salmon is particularly relevant, especially during the larval stage, since they need high-energy demands and rapid lipid metabolism. As a vital essential fatty acid, linoleic acid (18:2n-6) also plays an important role in the larval stage due to the production of longer-chained and more essential highly unsaturated fatty acids (HUFA). However, there is a lack of knowledge about the dietary linoleic acid (18:2n-6) requirement for this fish species. In this study, six isonitrogenous and isolipidic diets were formulated to contain different dietary linoleic acids (18:2n-6) by increasing corn oil at the expense of coconut oil to study the growth performance, fatty acid profile, and hepatic lipid metabolism enzymes of coho salmon alevins. The results showed that the dietary linoleic acid (18:2n-6) affected the growth performance, muscle fatty acid profile, and hepatic lipid metabolism enzyme activities of coho salmon, and determined the optimal demand of linoleic acid based on the specific growth rate (SGR) and feed conversion ratio (FCR).A 12-week feeding trial aimed to evaluate the effects of dietary linoleic acid (LA, 18:2n-6) on the growth performance, fatty acid profile, and lipid metabolism enzyme activities of coho salmon (Oncorhynchus kisutch) alevins. Six experimental diets (47% crude protein and 15% crude lipid) were formulated to contain graded LA levels of 0.11%, 0.74%, 1.37%, 2.00%, 2.63%, and 3.26%. Each diet was fed to triplicate groups of 50 alevins with an initial body weight of 0.364 ± 0.002 g, which were randomly assigned to 18 white plastic tanks (0.8 × 0.6 × 0.6 m, 240 L/tank). Fish were reared in a freshwater flow-through rearing system and fed to apparent satiation four times daily. The survival rate was not significantly different among the treatments (p > 0.05). However, the 1.37% LA group significantly improved the final body weight and specific growth rate (SGR) (p < 0.05) of alevins. The feed conversion ratio (FCR) in the 1.37% LA group was significantly lower than those in other groups (p < 0.05). The whole-body lipid content significantly decreased (p < 0.05) with dietary LA levels increasing from 0.74% to 2.00%. The fatty acid composition of the total lipid in muscle was closely correlated with those in the diets. The dietary LA level of 1.37% led to significantly higher activities of liver lipoprotein lipase (LPL) and hepatic lipase (HL) than those of other groups (p < 0.05). Hepatic malate dehydrogenase (MDH) and fatty acid synthase (FAS) decreased with the increase in the dietary LA levels from 0.11% to 1.37%. The lowest MDH and FAS activities were obtained in the 1.37% LA group (p < 0.05). This study indicated that an appropriate amount of dietary LA was beneficial for the growth and lipid metabolism of coho salmon alevins, and the results of the quadratic regression analysis of the SGR and FCR indicated that the optimal dietary LA requirements were 1.25% and 1.23% for coho salmon alevins, respectively.

Total hip replacement performed via a direct anterior approach: A comparison of the lateral and supine position

BackgroundThe direct anterior approach (DA) is a recognised approach for performing a total hip replacement (THR). Proponents cite improved recovery times, lower pain levels and improved patient satisfaction in the early post operative period. The procedure can be performed in the supine or lateral position. We wanted to compare the direct anterior approach in lateral decubitus (LD) position and supine (SU) position. MethodsSingle site, non-randomised, multiple surgeon retrospective cohort study between 2014 and 2021 to compare outcomes, complications and implant position for patients undergoing DAA THR in the SU or LD position. ResultsA total of 39 patients (22 lateral/17 supine) were identified. Patients had an average follow up of 45 months (17–81). 95% of the cohort were ASA 1 or 2. The majority of cases were uncemented (95%). A greater implant selection was used in the lateral group and the supine group used mainly implants associated with the supine table. No significant differences were found in post operative oxford hip scores, haemoglobin, length of stay, operative time, cup inclination, offset or post operative leg length. There were no recorded intra-operative complications in the LA group and two in the SU group – one calcar fracture and one canal perforation. No patient in either group has undergone a revision procedure. ConclusionBoth the supine and lateral position have resulted in satisfactory patient and radiological outcomes. We identified a higher rate of intra-operative fracture in the supine group which is comparable with existing literature. Given the similar outcomes between both groups we would suggest that surgeons wishing to consider the DAA may consider performing this in the lateral position as this will be more familiar to them, they will be able to use their existing implants and do not need a specialised operating table.

Effect of Segregation of Sc, Y and La Atoms on Prenucleation at the Liquid-Al/γ-Al2O3{1 1 1} Interfaces

γ-Al2O3 particles form inevitably in liquid Al- alloys during liquid-handling and casting processes. Such oxide particles may act as potential nucleation sites during solidification. Recent research revealed that native γ-Al2O3 particles exhibit different potency for nucleating solid Al, which may reduce the number of potential nucleation sites in the liquid. Chemical segregation at the liquid/oxide interface may modify the substrates’ nucleation potency. In this paper, we investigated prenucleation at the Al(l)/γ-Al2O3 interface with segregation of Sc, Y and La (Group 3) atoms using an ab initio molecular dynamics simulation technique. Our results revealed that the segregation of Sc, Y and La results in a reconstruction of the Al atoms adjacent to the substrates and consequently a rough substrate surface. Present investigation opens a new path for manipulating solidification processes via chemical segregation at the liquid/substrate interface.

Diagnostic significance of lactate dehydrogenase in measles virus reinfection cases.

Lactate dehydrogenase (LDH) levels in measles virus (MeV) reinfection cases for the diagnosis of measles have not been extensively studied. Thus, we evaluated the significance of serum LDH in the immune response of patients with MeV reinfection in comparison with those of patients with primary infection. Among 70 patients who tested positive for MeV-RNA, 42 with high MeV-specific IgG avidity (HA) were suspected as cases of reinfection and 28 with low MeV-specific IgG (LA) were suspected as cases of primary infection. The viral loads in the HA group were also lower than those in the LA group (P < 0.001). The titers of MeV-specific IgM and IgG in the HA group were significantly lower and higher, respectively, than those in the LA group (P < 0.001). The total LDH and LDH isozyme levels were elevated in the LA group compared with those in the HA group (P < 0.001). Through receiver operating characteristic curve analyses, we determined that the area under the curve of total LDH level was 0.87 (95% CI 0.74-1.00) and that the discriminatory accuracy was high for total LDH and all isozymes. By stepwise binary logistic regression analysis considering MeV-specific IgG avidity, we developed a model using IgG, IgM, and total LDH as explanatory variables, which was optimal for distinguishing the LA and HA groups (adjusted R2 = 0.773, P < 0.001). Thus, the serum LDH level in addition to IgM and IgG may be useful parameters for differentiating MeV reinfection from primary infection.

Lateral coagulation of the uterine artery at its origin prior to total laparoscopic hysterectomy. A randomized control trial

Background and ObjectivesLateral occlusion prior to TLH has been suggested to reduce perioperative bleeding, operative time, and hospital stay. Furthermore, reducing the amount of bleeding and the length of the operation may affect parameters such as postoperative pain and the number of patients with postoperative vaginal vault hematoma. MethodsThis RCT was conducted at a single center at Odense University Hospital in Denmark. Between February 2016 and February 2019, a total of 58 patients undergoing TLH and bilateral salpingectomy for benign cases were recruited to the study. ResultsThe mean operating time was significantly longer in the LA group with a mean difference between the two groups of six minutes. No other discrepancy regarding the primary outcomes was observed between the two groups. Total blood loss was similar in the two groups as well as the average hospital stay and the VAS score during the first seven days. 93% of the patients were discharged from the hospital within the first 24 h postoperatively. ConclusionThis RCT demonstrates that lateral occlusion of the uterine artery prior to TLH does not improve outcome for the patients and should therefore not be used as a standard procedure.

Medium Activity Prevents Periprosthetic Bone Mass Loss in the Medial Metaphyseal Region of the Tibia after Posterior-Stabilized TKA: A 5-Year Follow-up Study of 110 Knees.

ObjectiveThe bone mass around the prosthesis plays an important role in the stability of the prosthesis. This study aimed to assess the effect of postoperative activity on bone mineral density (BMD) in the proximal tibia 5 years after total knee arthroplasty (TKA). To provide a scientific guidance for postoperative functional exercise.Methods110 patients underwent unilateral primary TKA were divided into three groups based on the University of California Los Angeles (UCLA) activity scale: low activity group (LA group, UCLA = 4, 5); medium activity group (MA group, UCLA = 6, 7); and high activity group (HA group, UCLA = 8, 9). The primary observation was a comparison of the BMD and BMD change percentage (ΔBMD (%)) in the periprosthetic tibia among the LA, MA and HA groups at 1 year, 3 years and 5 years. The secondary observations were radiographic evaluation (prosthetic stability, periprosthetic fractures, aseptic loosening and periprosthetic joint infection) and clinical evaluation (Knee Society Score (KSS), visual analogue score scores and range of motion (ROM)). A one‐way ANOVA was used to compare the clinical scores and BMD among the three groups.ResultsThe BMD of medial region decreased by 10.80%, 12.64%, 13.61% at 1, 3, and 5 years respectively; these were 5.72%, 6.26%, 7.83% in lateral region and 1.42%, 1.78%, 3.28% in diaphyseal region. For medial metaphyseal region, the BMD of the MA group was significantly greater than that of the LA and HA groups at 1 and 3 years (108.9 ± 5.2 vs. 106.1 ± 6.69 vs. 105.4 ± 5.2 and 108.5 ± 6.0 vs. 101.2 ± 6.76 vs. 103.0 ± 6.8, P < 0.01 and P < 0.001), and the BMD changes (ΔBMD (%)) in the MA group were significantly smaller than those in the LA and HA groups (8.75 ± 5.36 vs. 11.92 ± 5.49 vs. 12.70 ± 5.21 and 9.11 ± 5.11 vs. 16.04 ± 4.79 vs. 14.82 ± 4.26, P < 0.01 and P < 0.001).Regarding secondary observations, all of the prostheses were assessed as stable, without periprosthetic fractures, aseptic loosening and periprosthetic joint infection. Regarding KSS scores, there was no significant difference among the three groups. However, the VAS and ROM of the HA group were better than those of the MA and LA groups (1.65 ± 0.79 vs. 2.63 ± 0.77 vs. 3.00 ± 1.17, p < 0.001, and 111.90 ± 9.17 vs. 110.20 ± 6.78 vs. 102.90 ± 8.48, P < 0.001).ConclusionMedium activity prevented periprosthetic bone loss in the medial metaphyseal region of the tibia after posterior‐stabilized TKA, and moderate‐intensity exercise is recommended for patients after TKA to reduce periprosthetic bone loss.