Longer Time Research Articles

Sex Differences in Depressive Symptoms in 1308 Patients Post-Stroke at Entry to Cardiac Rehabilitation.

The objective of this study was to determine whether a sex difference exists in the prevalence of post-stroke depressive symptoms (PSDS) at entry to cardiac rehabilitation (CR) and to determine the correlates of PSDS in all patients, and in women and men separately. People post-stroke at entry to CR from database records (2006-2017) were included. Bivariate analyses identified PSDS correlates (≥16 on the Center for Epidemiologic Studies Depression Scale) in all patients and women and men separately. Patients (n = 1308, 28.9% women), mean age of 63.9 ± 12.9 yr, were 24.2 ± 9.9 mo post-stroke at CR entry. Among all patients, 30.0% had PSDS. A greater proportion of women than men had PSDS (38.6 vs 26.6%; P < .001). Correlates of PSDS in all patients were sex (women) (OR = 1.6: 95% CI, 1.14-2.12), being unemployed, ≤60 yr old, prescribed antidepressant medication, having lower cardiorespiratory fitness (peak oxygen uptake [V̇ o2peak ]), chronic obstructive pulmonary disease (COPD), higher body mass index (BMI), no transient ischemic attack, and longer time from stroke to CR entry (>12 mo). Correlates in women were being obese (BMI ≥ 30), 51-70 yr old, prescribed antidepressant medication, and not married. Correlates in men were being ≤60 yr old, unemployed, prescribed antidepressant medication, having lower V̇ o2peak , sleep apnea, COPD, and no hypertension. Women were disproportionately affected by PSDS at entry to CR in bivariate and multivariable analyses. Women and men had mostly unique correlates of PSDS, indicating tailored strategies to address PSDS are required. PSDS disproportionately affected patients with longer delay to CR entry, suggesting efforts should target timely referral to facilitate earlier and repeated assessments and management.

Mechanisms of Injury Leading to Concussions in Collegiate Soccer Players: A CARE Consortium Study

Background: Few previous studies have investigated how different injury mechanisms leading to sport-related concussion (SRC) in soccer may affect outcomes. Purpose: To describe injury mechanisms and evaluate injury mechanisms as predictors of symptom severity, return to play (RTP) initiation, and unrestricted RTP (URTP) in a cohort of collegiate soccer players. Study Design: Cohort study; Level of evidence, 2. Methods: The Concussion Assessment, Research and Education (CARE) Consortium database was used. The mechanism of injury was categorized into head-to-ball, head-to-head, head-to-body, and head-to-ground/equipment. Baseline/acute injury characteristics—including Sports Concussion Assessment Tool–3 total symptom severity (TSS), loss of consciousness (LOC), and altered mental status (AMS); descriptive data; and recovery (RTP and URTP)—were compared. Multivariable regression and Weibull models were used to assess the predictive value of the mechanism of injury on TSS and RTP/URTP, respectively. Results: Among 391 soccer SRCs, 32.7% were attributed to a head-to-ball mechanism, 27.9% to a head-to-body mechanism, 21.7% to a head-to-head mechanism, and 17.6% to a head-to-ground/equipment mechanism. Event type was significantly associated with injury mechanism [χ2(3) = 63; P < .001), such that more head-to-ball concussions occurred in practice sessions (n = 92 [51.1%] vs n = 36 [17.1%]) and more head-to-head (n = 65 [30.8%] vs n = 20 [11.1]) and head-to-body (n = 76 [36%] vs n = 33 [18.3%]) concussions occurred in competition. The primary position was significantly associated with injury mechanism [χ2(3) = 24; P < .004], with goalkeepers having no SRCs from the head-to-head mechanism (n = 0 [0%]) and forward players having the least head-to-body mechanism (n = 15 [19.2%]). LOC was also associated with injury mechanism (P = .034), with LOC being most prevalent in head-to-ground/equipment. Finally, AMS was most prevalent in head-to-ball (n = 54 [34.2%]) and head-to-body (n = 48 [30.4%]) mechanisms [χ2(3) = 9; P = .029]. In our multivariable models, the mechanism was not a predictor of TSS or RTP; however, it was associated with URTP (P = .044), with head-to-equipment/ground injuries resulting in the shortest mean number of days (14 ± 9.1 days) to URTP and the head-to-ball mechanism the longest (18.6 ± 21.6 days). Conclusion: The mechanism of injury differed by event type and primary position, and LOC and AMS were different across mechanisms. Even though the mechanism of injury was not a significant predictor of acute symptom burden or time until RTP initiation, those with head-to-equipment/ground injuries spent the shortest time until URTP, and those with head-to-ball injuries had the longest time until URTP.

Dosimetric analysis of different optimization algorithms for three-dimensional brachytherapy for gynecologic tumors

To investigate the dosimetric difference between manual and inverse optimization in 3-dimensional (3D) brachytherapy for gynecologic tumors. This retrospective study was conducted among a total of 110 patients with gynecologic tumors undergoing intracavitary combined with interstitial brachytherapy or interstitial brachytherapy. Based on the original images, the brachytherapy plans were optimized for each patient using Gro, IPSA1, IPSA2 (with increased volumetric dose limits on the basis of IPSA1) and HIPO algorithms. The dose-volume histogram (DVH) parameters of the clinical target volume (CTV) including V200, V150, V100, D90, D98 and CI, and the dosimetric parameters D2cc, D1cc, and D0.1cc for the bladder, rectum, and sigmoid colon were compared among the 4 plans. Among the 4 plans, Gro optimization took the longest time, followed by HIPO, IPSA2 and IPSA1 optimization. The mean D90, D98, and V100 of HIPO plans were significantly higher than those of Gro and IPSA plans, and D90 and V100 of IPSA1, IPSA2 and HIPO plans were higher than those of Gro plans (P < 0.05), but the CI of the 4 plans were similar (P > 0.05). For the organs at risk (OARs), the HIPO plan had the lowest D2cc of the bladder and rectum; the bladder absorbed dose of Gro plans were significantly greater than those of IPSA1 and HIPO (P < 0.05). The D2cc and D1cc of the rectum in IPSA1, IPSA2 and HIPO plans were better than Gro (P < 0.05). The D2cc and D1cc of the sigmoid colon did not differ significantly among the 4 plans. Among the 4 algorithms, the HIPO algorithm can better improve dose coverage of the target and lower the radiation dose of the OARs, and is thus recommended for the initial plan optimization. Clinically, the combination of manual optimization can achieve more individualized dose distribution of the plan.

Understanding the atmospheric cold plasma-induced modification of finger millet (Eleusine coracana) starch and its related mechanisms

This research was conducted to evaluate the effects of cold plasma (CP) on finger millet starch (FMS). FMS was exposed to partially ionized gas at varying voltages (170, 200, and 230 Volt) for varied time (10, 20, and 30 mins). The impact of treatment was studied using physico-chemical, and functional properties, and the mechanisms of starch modification occurring were stated. A significant reduction in the degree of polymerization was noticed based on parameters like reducing sugar, amylose content, solubility, and molecular weight. However, in certain voltage and time combinations, crosslinking was also confirmed by analysis such as XRD, FTIR, DSC, etc. The properties of starch were altered such as remarkable increase in water solubility by 6.7 times for highest voltage and longest time (230 V/30 min) was registered. NMR data suggested valuable findings- oxidation of OH group at C6 position of starch led to formation of carbonyl group followed by carboxyl group. NMR also showed a decrease in OH protons confirming crosslinking and hence all these analyses helped to conclude findings about the quality changes using CP. It was observed that the highest voltage and considerably longer exposure time of 20 and 30 min induced significant changes in the FMS.

341 Racial Disparities in Incidence, Treatment, and Survival in Adult Brain Metastases: A 10-Year National Database Analysis

INTRODUCTION: Brain metastases are the most common central nervous system tumors in the United States. It is imperative to understand how prognosis and survival varies demographically to ensure equitable care for vulnerable populations and reduce financial burdens on the healthcare system. METHODS: Using the Surveillance, Epidemiology, and End Result Program (SEER) database, adults with non-primary brain metastases between 2010 and 2019 were identified. The primary outcome measure was all-cause mortality within 5 years. Chi-squared tests of independence and one way analyses of variance were used to compare group differences between White, Black, Asian/Pacific Islander (A/PI), and American Indian/Alaskan Native patients. A Cox proportional hazards model was developed to evaluate the risk of death within 5 years. RESULTS: A total of 65,154 patient records were identified following exclusion based on age (&gt;84 years or &lt;18 years), missing race data, and missing survival data. The incidence of brain metastases increased from 2.53 per 100,000 adults in 2010 to 2.71 per 100,000 in 2019. A/PI patients had the highest population-adjusted incidence, highest population proportion of high income, the longest time from diagnosis to treatment, lowest rate of radiation refusal, and highest rate of chemotherapy treatment. Subsequently, A/PI patients had the highest 5-year survival rate compared to White and Black patients (9.05% vs. 4.15% vs. 3.23% respectively, p &lt; 0.001). Chemotherapy (OR = 0.44) and surgery (OR = 0.51) were the strongest protective factors against death while being widowed (OR = 1.15) and having primary lung cancer (OR = 1.14) strongest risk factors. CONCLUSIONS: A/PI patients also have a significant survival advantage compared to White, Black, and AI/AN patients, potentially due to higher rates of radiation and chemotherapy treatment. Patients of other races are recommended treatment at lower rates than A/PI patients, suggesting a discrepancy in services offered to these patients.

Skin marker combined with surface-guided auto-positioning for breast DIBH radiotherapy daily initial patient setup: An optimal schedule for both accuracy and efficiency.

By employing three surface-guided radiotherapy (SGRT)-assisted positioning methods, we conducted a prospective study of patients undergoing SGRT-based deep inspiration breath-hold (DIBH) radiotherapy using a Sentine/Catalys system. The aim of this study was to optimize the initial positioning workflow of SGRT-DIBH radiotherapy for breast cancer. A total of 124 patients were divided into three groups to conduct a prospective comparative study of the setup accuracy and efficiency for the daily initial setup of SGRT-DIBH breast radiotherapy. Group A was subjected to skin marker plus SGRT verification, Group B underwent SGRT optical feedback plus auto-positioning, and Group C was subjected to skin marker plus SGRT auto-positioning. We evaluated setup accuracy and efficiency using cone-beam computed tomography (CBCT) verification data and the total setup time. In groups A, B, and C, the mean and standard deviation of the translational setup-error vectors were small, with the highest values of the three directions observed in group A (2.4±1.6, 2.9±1.8, and 2.8±2.1mm). The rotational vectors in group B (1.8±0.7°, 2.1±0.8°, and 1.8±0.7°) were significantly larger than those in groups A and C, and the Group C setup required the shortest amount of time, at 1.5±0.3min, while that of Group B took the longest time, at 2.6±0.9min. SGRT one-key calibration was found to be more suitable when followed by skin marker/tattoo and in-room laser positioning, establishing it as an optimal daily initial set-up protocol for breast DIBH radiotherapy. This modality also proved to be suitable for free-breathing breast cancer radiotherapy, and its widespread clinical use is recommended.

The use of geotextiles in agricultural soils and their effects on soil properties and nutrients availability. Are wastes plastics likely to become useful materials in agriculture?

Experiments were conducted in agricultural soils of central and northern Greece to simulate agricultural practices and to study the effect of geotextile particles on the physical and chemical properties of the soils. Geotextile was added to soil samples in different shapes, dimensions, and proportions (1, 2, and 4% v/v), which remained for different periods (10, 25, 50, 150 days). The physicochemical properties and their changes after adding the geotextile were determined in soil samples. Furthermore, the levels of nutrients in the soils and their changes were evaluated concerning the levels of added plastic and the time they remained in the soil. Once the plastic dimensions were sufficiently large (>5 mm), the changes in the organic matter content and the available trace elements concentration were most pronounced. Plastic residence time appears to be crucial, as the greatest changes in both exchangeable potassium and assimilable phosphorus were observed in the soil samples when the plastic was introduced at the microplastics dimensions (<5 mm), in its maximum amount (4% v/v), and remained within the soil over the longest time (150 days). Knowledge of the chemical composition along with the chemical behavior of plastics used in agricultural practices is particularly important, as it can lead to real benefits to the agricultural economy, being able to regulate the uptake and availability of nutrients already present bound in soils, and reducing the need for continuous need for fertilizer addition, in a circular economy approach.

Impact of Different Substrates on Growth and Yield of Schizophyllum commune Fr.

Schizophyllum communeFr. is an edible medicinal mushroom also known as white rot fungus that develops naturally on dead woods which belongs to the phylumBasidiomycota, order Agaricales, family Schizophyllaceae.To find out most suitable growing substrates, mushroom was cultivated on 6 locally available substrates including different saw dust i.e.Babool (Vachellianilotica),Bija (Petrocarpus marsupium),Sal (Shorea robusta),Sagwan (Tectona grandis) and different strawi.e. Paddy straw(PS) and Wheat straw(WS). Among the different substrates,on an average,WS took shortest time for mycelial run (6.50 days), longest time(8.62 days) taken by Bija (P. marsupium). Pinhead initiation was fastest (8.50 days) in WS while, Bija (P. marsupium)took more time period(10.62 days) for pinhead initiation. The Maximum yield was obtained from WS (148.37gm) with biological efficiency (29.6%) followed by PS(116.12 gm) with biological efficiency (23.2%). The lowest yield was obtained from saw dust of Bija (P. marsupium)(60.50gm) with biological efficiency (10.40%).There was significant difference in yield when supplement (wheat bran)was mixed with substrates, however there was no significant difference observed in mycelial run and pinhead initiation.

Abstract 800: Spatial accessibility of gynecologic oncologists and time to surgery in a diverse cohort of women with ovarian cancer in Northern California

Abstract Introduction: To expand our understanding of factors contributing to racial and ethnic disparities in ovarian cancer outcomes, we examined the association between spatial accessibility of gynecologic oncologists and time from cancer diagnosis to surgery in the KPROCS Study, a diverse cohort of women diagnosed with ovarian cancer between 2000-2018 at Kaiser Permanente Northern California (KPNC). Spatial medical accessibility is a component of healthcare access that captures the proximity and availability of healthcare resources in the area. Methods: Ovarian cancer cases were identified through the KPNC Cancer Registry. Demographic and clinical information was extracted from KPNC databases. Neighborhood characteristics from the California Neighborhoods Data System were linked to the residential addresses of cases at the time of diagnosis. Spatial medical accessibility was measured using the 2-step floating catchment area method based on the location of the infusion centers where KPNC gynecologic oncologists practice and the residence location of cohort members. We used generalized estimating equations with independent correlation structure and robust standard errors to examine the association between spatial accessibility of gynecologic oncologists and time to ovarian cancer surgery, adjusting for year and age at diagnosis, stage, histotype, race, ethnicity, neighborhood socioeconomic status (nSES), and receipt of neoadjuvant chemotherapy. Results: The cohort comprised 4,910 women with ovarian cancer, of whom 3,304 had surgery at KPNC. Of this group, 13% were Hispanic, 14% were non-Hispanic (NH) Asian American women, 5% NH Black women, and 67% NH White women. The proportion of women residing in areas of the lowest spatial accessibility of gynecologic oncologists was highest among NH White women (26%) and women residing in the highest quintile of nSES (29%). The median time from diagnosis to surgery was 4 days (interquartile range 22 days). In adjusted analyses, not including the information on spatial accessibility, the time from diagnosis to surgery was 5.1 days longer (95% CI 1.5, 8.7) for NH Black women than NH White women. After adding information on spatial accessibility, this time did not considerably change, resulting in a 5.3-day (95% CI 1.7, 8.9) difference. In this model, the lowest quintile of spatial accessibility of gynecologic oncologists was associated with a longer time from diagnosis to surgery, but this association was not statistically significant (0.4 days difference, 95% CI -1.3, 2.0). Summary: In our preliminary analyses, spatial accessibility of gynecologic oncologists was not found to be a contributing factor to the disparity in time from diagnosis to surgery between NH Black and NH White women. Further analyses will examine time from diagnosis to chemotherapy overall and stratified by racial and ethnic groups. Citation Format: Ekaterina Chirikova, Pushkar P. Inamdar, Valerie McGuire, Salma Shariff-Marco, Valerie S. Lee, Lindsay J. Collin, Carola T. Sanchez-Diaz, Juraj Kavecansky, C Bethan Powell, Jennifer A. Doherty, Lawrence H. Kushi, Elisa V. Bandera, Scarlett L. Gomez. Spatial accessibility of gynecologic oncologists and time to surgery in a diverse cohort of women with ovarian cancer in Northern California [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 800.

The effect of surgical time on perioperative complications in adolescent idiopathic scoliosis cases. A propensity score analysis.

Posterior spinal instrumentation and fusion (PSIF) for adolescent idiopathic scoliosis (AIS) can be lengthy and complication-ridden. The aim of this study was to evaluate the effect of surgical time on perioperative complications in this procedure when controlling for confounding variables with propensity score analysis. This was an IRB-approved review of electronic health records from 2010 to 2019 at a single tertiary care children's hospital. Patients undergoing PSIF were grouped into "short" (< 6h) or "long" (≥ 6h) surgical time groups. Outcome measures were estimated blood loss (EBL), cell saver transfusions, packed red blood cell (pRBC) transfusions, length of stay (LOS), intraoperative monitoring (IOM) alerts, hematocrit, ICU transfer, neurologic loss, surgical site infection, and 90-day readmissions. We controlled for age, sex, BMI, curve severity, number of segments fused, and surgeon factors. After propensity score matching there were 113 patients in each group. The short surgical time group had lower EBL (median 715, IQR 550-900 vs median 875, IQR 650-1100cc; p < 0.001), received less cell saver blood (median 120, IQR 60-168 vs median 160, IQR 97-225cc; p = 0.001), received less intraoperative pRBCs (median 0, IQR 0-0 vs median 0, IQR 0-320, p = 0.002), had shorter average LOS (4.8 ± 1.7 vs 5.4 ± 2.5days; p = 0.039), and fewer IOM alerts (4.3% vs 18%, p = 0.003). Patients with shorter surgical times had less blood loss, received less transfused blood, had a shorter LOS, and fewer IOM alerts compared to patients with longer surgical times. Surgical times < 6h may have safety and efficacy advantages over longer times. III.

The effects of trait and state anxiety on gait in healthy young adults.

Stable, personality-based (trait), and fluctuating, situational (state) anxiety have both been shown to consume attentional resources and reduce functional cognitive capacity, which may play a role in gait control. However, the role of attention in the relationship between trait and state anxiety has not yet been investigated formally. This study used a virtual reality-threat environment to evaluate whether changes in attention mediate the effects of state and trait anxiety on gait. Thirty adults aged 19-28 completed five walking trials in four conditions: (i) low threat-walking across a virtual plank (0.5m wide) on flat ground; (ii) low threat + dual task (auditory digit monitoring); (iii) high threat-walking across a virtual plank elevated above a deep pit; and (iv) high threat + dual task. Trait anxiety levels were determined by the State-Trait Anxiety Inventory, while state anxiety was captured using self-assessment manikins. Higher trait anxiety predicted slower gait velocity and longer time in double support in the high-threat condition compared to low-threat condition (i vs iii), but not when dual tasking, compared to single-task walking, in the absence of threat (ii vs i). Additionally, higher trait anxiety predicted increased step length variability in the high compared to low-threat dual-task condition. Overall, trait anxiety predicts a slower, more cautious gait pattern during threatening conditions while dual tasking during the threat.

Trends in management and outcomes of colon cancer in the United States over 15 years: Analysis of the National Cancer Database.

Management of colon cancer has changed over the last few decades. We assessed the trends in management and outcomes using the US National Cancer Database (NCDB). A retrospective analysis of all patients with colonic adenocarcinoma between 2005 and 2019 was conducted. The cohort was divided into three equal time periods: Period 1 (2005-2009), Period 2 (2010-2014), and Period 3 (2015-2019) to examine treatment and outcomes trends. The primary outcome was 5-year overall survival (OS). The study included 923,275 patients. A significant increase in patients with stage IV disease was noted in Period 3 compared to Period 1 (47.9% vs. 27.9%, respectively), whereas a reciprocal reduction was seen in patients with locally advanced disease (stage II: 20.8%-12%; stage III: 14.5%-7.7%). Use of immunotherapy significantly increased from 0.3% to 7.6%. Mean 5-year OS increased (43.6 vs. 42.1 months) despite the increase in metastatic disease and longer time from diagnosis to definitive surgery (7 vs. 14 days). A reduction in 30-day readmission (5.1%-4.2%), 30- (3.9%-2.8%), and 90-day mortality (7.1%-5%) was seen. Laparoscopic and robotic surgery increased from 45.8% to 53.1% and 2.9% to 12.7%, respectively. Median postoperative length of hospital stay decreased by 2 days. Rate of positive resection margins (7.2%-6%) and median number of examined lymph nodes (14-16) also improved. Minimally invasive surgery and immunotherapy for colon cancer significantly increased in recent years. Patient outcomes including OS improved over time.

The serological immunogenicity of the third and fourth doses of COVID-19 vaccine in patients with inflammatory rheumatic diseases on different biologic or targeted DMARDs: a Swedish nationwide study (COVID-19-REUMA).

Results from this study provide further evidence that additional doses of COVID-19 vaccines are immunogenic and result in satisfactory antibody response in a majority of patients with inflammatory rheumatic diseases (IRD) receiving potent immunomodulating treatments such as biological or targeted disease-modifying anti-rheumatic drugs (DMARDs) given as monotherapy or combined with traditional DMARDs. We observed that rituximab treatment, both as monotherapy and combined with csDMARDs, impaired antibody response, and only roughly 50% of patients developed a satisfactory antibody response including response to omicron subvariants after the third vaccine. In addition, higher IgG levels at the last rituximab course before the third vaccine dose and a longer time after the last rituximab treatment increased the chance of a satisfactory antibody response. These results indicate that rituximab-treated patients should be prioritized for additional vaccine doses. EudraCT (European Union Drug Regulating Authorities Clinical Trials Database) with number 2021-000880-63.

The negative impact of treatment delays on the long-term neurological outcomes of spinal dural arteriovenous fistulas: a longitudinal cohort study.

Dural arteriovenous fistulas are rare vascular malformations that affect the brain and spinal cord. Spinal dural arteriovenous fistulas (sdAVFs) are the most frequently encountered vascular malformation affecting the spinal cord. The object of this study was to evaluate the impact of treatment delays on the long-term neurological outcomes of either open surgical or interventional treatment of sdAVFs. In this retrospective, population-based cohort study, the authors examined consecutive patients with diagnosed sdAVFs at a tertiary care center between 2005 and 2020. Patients were assessed using the Aminoff-Logue disability scale (ALS) at various time points including symptom onset, primary care visit, first specialist outpatient visit, as well as both short and long-term follow-ups. The postoperative long-term ALS gait and bladder grades constituted the primary outcomes of the study. Among the 34 patients included in the study, the median age was 65 years, and there was a male predominance (71%). Most lesions were in the lumbar region (47%). Significant worsening in ALS gait and bladder grades was observed preoperatively, followed by postoperative improvements (p < 0.05). There was no difference in outcomes between surgical and endovascular treatments. Older age (OR 1.10, 95% CI 1.03-1.17, p = 0.007), worse preoperative ALS gait grades (OR 5.12, 95% CI 2.18-12.4, p < 0.001), and longer time from first specialist outpatient visit to first treatment (OR 1.00, 95% CI 1.00-1.01, p = 0.040) were independently associated with worse long-term gait outcomes. Only the preoperative ALS bladder score was a predictor of worse long-term bladder function (OR 92.7, 95% CI 28.0-306.7, p < 0.001). Both surgical and endovascular treatments for sdAVFs led to significant neurological improvements. However, treatment delays were associated with less favorable long-term outcomes. Prompt diagnosis and early intervention prior to symptom progression may enhance recovery and help to preserve neurological function.

Retrospective Study of Patients Submitted to Appendectomy in a Tertiary Hospital: Is There a Difference between the Public and Supplementary Health System?

Abstract Introduction Appendicitis is the surgical disease with the highest prevalence in emergency rooms. Its clinical and/or surgical complications are associated with the time course of symptoms, age, comorbidities, and stages of the disease. Objectives To analyze the demographic and clinical data of patients who underwent appendectomy for acute appendicitis in a tertiary referral hospital in the city of São Paulo and compare these data between services provided by the Public and Supplementary Health System. Methodology Retrospective analysis of data from electronic medical records of patients over 14 years old who underwent appendectomy for acute appendicitis at Hospital Santa Marcelina, both in the Public and Supplementary Health Systems from January 2015 to December 2017. Results A total of 536 patients were analyzed, 354 (66%) of whom were male with a general mean age of 29.85 years (14–81 years). The mean time from symptoms to seeking medical care was 53.84 hours. Regarding the phases of acute appendicitis, a greater number of cases of complicated disease was observed in patients operated on in the Public Health System (p &lt; 0.0001), as well as the time course of symptoms (p = 0.0005) and hospitalization (p = 0.0012). On the other hand, the surgical wound infection rate during the hospitalization period was similar between groups (p = 0.2118). Conclusion There was a predominance of male patients undergoing appendectomy for acute appendicitis, with longer time course of symptoms in those operated on in the Public Health System and a predominance of appendicitis in advanced stages (3 and 4) in this group. However, in this group there was no significant increase in the rate of postoperative infection, and the length of stay was shorter than that of patients operated on in the Supplementary Health System.

Mouse kidney transplantation model: Three novel methods.

The mouse kidney transplantation model presents challenges in terms of surgical difficulty and low success rate, making it difficult to master. This study aims to provide a crucial model for transplantation immunology research by modifying and developing novel techniques for mouse kidney transplantation. A total of 57 pairs of mice were used to establish and compare the modified and innovative surgical techniques for mouse kidney transplantation. Three different surgical models were established, including the abdominal suture technique for orthotopic kidney transplantation, the abdominal cuff technique for orthotopic kidney transplantation, and the cervical cuff technique for ectopic kidney transplantation. BALB/c or C57BL/6 male mice, aged 8 to 12 weeks and weighed 20 to 25 g with specified pathogen free-grade were served as the donor mice or the recipient mice. The surgical technique characteristics, key surgical times, complications, and pathological examination in the early postoperative period were summarized and compared. Three different surgical models of mouse kidney transplantation were successfully established. The comparison of warm ischemic time for the 3 groups of mice showed no statistical significance (P=0.510 4). The abdominal suture group had the shortest total operation time of the donor compared with the abdominal cuff group and the cervical cuff group [(18.3±3.6) min vs (26.2±4.7) min and (22.8±2.5) min; both P<0.000 1]. There was a significant difference in cold ischemia time among the 3 groups (all P<0.000 1), with (60.8±4.1) min in the cervical cuff group, (43.3±5.0) min in the abdominal suture group, and (88.8±6.7) min in the abdominal cuff group. Due to different anastomosis methods, the cervical cuff group had the shortest time [(17.6±2.7) min], whereas the abdominal cuff group had the longest time [(38.8±5.4) min]. The total operation time for the recipients showed significant differences (P<0.000 1), with the abdominal suture group having the shortest time [(44.0±6.9) min], followed by the cervical cuff group [(64.1±5.2) min], and the abdominal cuff group [(80.0±6.0) min] being the longest. In the 32 mice of the abdominal suture group, there were 6 with intraoperative bleeding, including 1 arterial intimal injury bleeding and 5 with bleeding after vessel opening. Six mice had ureteral complications, including ureteral bladder anastomotic stenosis, necrosis, and renal pelvis dilation. Two mice had postoperative abdominal infections. In the abdominal cuff group, there was no intraoperative bleeding, but 6 mice showed mild arterial stenosis and 5 showed venous stenosis, 4 arterial injury, 4 arterial thrombosis, and 2 ureteral complications. No postoperative infections occurred in the mice. In the cervical cuff group, no intraoperative bleeding, arterial intimal injury, arterial/venous stenosis, or thrombosis were found in 13 mice. Five mice had ureteral complications, including ureteral necrosis and infection, which were the main complications in the cervical cuff group. The renal function in mice of the 3 groups remained stable 7 days after surgery. Hematoxylin and eosin staining and periodic acid-Schiff staining showed no significant differences in terms of acute rejection among the 3 surgical methods (all P>0.05). All 3 surgical methods are able to successfully establish mouse kidney transplantation models, with no significant differences observed in the short-term graft survival and acute rejection. The modified abdominal suture technique and abdominal cuff technique have their respective advantages in research applications. The novel cervical cuff technique for ectopic kidney transplantation model is relatively simple to be prepared and causes less trauma to the mice, providing more options for studies involving xenotransplantation, secondary transplantation, and local lymphatic drainage. However, the difficulty in harvesting the donor kidney and the high incidence of ureteral infections need further validation in long-term survival. This study holds important reference value for choosing the type of mouse kidney transplantation model for different research needs.

Simple Model for Temporal Variations of Hα Spectrum by an Eruptive Filament from a Superflare on a Solar-type Star

Flares are intense explosions on the solar and stellar surfaces, and solar flares are sometimes accompanied by filament or prominence eruptions. Recently, a large filament eruption associated with a superflare on a solar-type star EK Dra was discovered for the first time. The absorption of the Hα spectrum initially exhibited a blueshift with the velocity of 510 km s−1, and decelerated in time probably due to gravity. Stellar coronal mass ejections (CMEs) were thought to occur, although the filament eruption did not exceed the escape velocity under the surface gravity. To investigate how such a filament eruption can occur and whether CMEs are associated with the filament eruption or not, we perform a one-dimensional hydrodynamic simulation of the flow along an expanding magnetic loop emulating a filament eruption under adiabatic and unsteady conditions. The loop configuration and expanding velocity normal to the loop are specified in the configuration parameters, and we calculate the line-of-sight velocity of the filament eruption using the velocities along and normal to the loop. We find that (i) the temporal variations of the Hα spectrum for EK Dra can be explained by a falling filament eruption in the loop with longer time and larger spatial scales than that of the Sun, and (ii) the stellar CMEs are also thought to be associated with the filament eruption from the superflare on EK Dra, because the rarefied loop unobserved in the Hα spectrum needs to expand faster than the escape velocity, whereas the observed filament eruption does not exceed the escape velocity.

The impact of HIV self-testing on risk behaviors among men who have sex with men: a mixed-methods study.

Men who have sex with men (MSM) have a high prevalence of HIV and a low rate of HIV testing in China. HIV self-testing (HIVST) presents a viable strategy for expanding HIV testing among MSM. However, the impact of HIVST on risk behaviors among MSM remains controversial. Our study sought to ascertain this impact. From April 2021 to January 2022, a mixed-methods study was conducted in Qingdao City, employing both quantitative and qualitative methodologies. The quantitative component entailed a cohort study among MSM who had used HIVST. Generalized estimating equations fitting Poisson regressions were used to analyze the changes in risk behaviors of MSM in short time after HIVST (ST-HIVST) and longer time after HIVST (LT-HIVST) compared to before HIVST. Subsequently, we conducted in-depth interviews with 18 MSM who completed the follow-up to delve deeper into the impact of HIVST on MSM. A total of 410 MSM were recruited in the cohort, of whom 83 were lost to follow-up. Compared to before HIVST, there were no significant changes in risk behaviors in ST-HIVST (p > 0.05), while the proportion of recreational drugs abuse (20.7% vs. 33.3%), commercial sex (14.6% vs. 22.9%), and unprotected anal sex (95.9% vs. 98.5%) increased significantly in LT-HIVST (p < 0.05). Specific changes varied across demographic characteristics. According to qualitative interviews, MSM might have decreased risk perception and increased risk behaviors after HIVST. The use of HIVST may promote MSM to engage in risk behaviors. In the future, customized HIVST promotion programs need to be developed to expand HIV testing among MSM and simultaneously control their risk behaviors.

Robot-assisted radical prostatectomy in patients after endoscopic surgeries on the prostate

Background. In literature, data on the results of robot-assisted radical prostatectomy (RARP) in patients after transurethral resection of the prostate (TURP) are contradictory.Aim. To evaluate surgical, functional, and oncological outcomes of RARP after TURP.Materials and methods. At the Urology Center of the Mariinsky Hospital (Saint Petersburg), RARP was performed on 410 patients. Among them, 28 (6.8 %) patients (1st group) previously underwent TURP due to infravesical obstruction. Among them, 18 (64.3 %) patients were diagnosed with prostate cancer after pathomorphological examination of the tissue resected during TURP, and on them RARP was performed on average 3.2 months later. In 10 (35.7 %) patients, prostate cancer was diagnosed during transrectal biopsy due to increased prostate-specific antigen level; on them RARP was performed on average 42.0 months after TURP. The following parameters were evaluated: operative time, time of bladder neck reconstruction and urethrovesical anastomosis formation, blood loss volume, tumor pathological stage, Gleason score, surgical margin status, rates of urine continence and preservation of erectile function.Results. Mean operative time was higher in the 1st group compared to the 2nd: 210 ± 36 min versus 180 ± 25 min (р &lt;0.0001). In the 1st group compared to the 2nd, reconstruction of bladder neck was necessary more frequently (82.1 % versus 10.7 %; р &lt;0.0001), urethrovesical anastomosis took longer time (32 ± 2.3 min versus 24.5 ± 3.1 min; р &lt;0.0001), mean blood loss volume was higher (240 ± 39 mL versus 170 ± 32 mL; р &lt;0.0001). Frequencies of positive surgical margin were 14.3 and 10.7 % respectively in the 1st and 2nd groups (р = 0.840). Frequencies of all complications were 28.6 and 21.4 %, respectively. Severe complications (≥IIIb grade per the Clavien classification) were observed in 2 (7.1 %) patients in both groups. Frequency of anastomosis stricture after surgery was significantly higher in the 1st group: in 2 (7.1 %) and 1 (3.6 %) case, respectively (р &lt;0.05). In the 1st group, total urinary continence was achieved in 14 (50.0 %), 20 (71.5 %), 22 (78.5 %) and 25 (89.3 %) patients at early and 3-, 6and 12-month follow-up after RARP; in the 2nd group, it was achieved in 18 (64.3 %), 22 (78.6 %), 24 (85.7 %) and 26 (92.9 %) patients in the same follow-up periods. After 6 and 12 months, in the 1st group among 15 (53.6 %) patients with normal initial erectile function, satisfactory erectile function was preserved in 46.7 and 93.3 % of patients; in the 2nd group among 19 (67.8 %) patients, in 57.8 and 94.7 % patients, respectively.Conclusion. RARP after TURP is a relatively complicated surgical intervention with long operative time and high blood loss volume. However, functional and short-term oncological outcomes of RARP in these patients do not differ at 12 months.

Effect of two recombinant bovine somatotropin formulations on feeding behavior and metabolism of Holstein cows

This study evaluated the effect of two commercial forms of recombinant bovine somatotropin (rbST; Later® and Fast®; 500 mg) on feed variability, feeding behavior, zootechnical parameters, and milk production of Holstein cows after peak production. Eighteen cows were randomly divided into two groups and treated with injectable of rbST every 14 days for 70 days. Blood samples were collected on day 1, 4, and 7 of each cycle, to assess circulating levels of non-esterified fatty acids (NEFA). Weight and body condition score (BCS) assessments were performed. Milk yields were measured daily using the DelPro™ software (DeLaval®). Feed consumption and feeding behavior was obtained daily using automatic individual feeders (Intergado®). No difference was observed in dry matter intake (DMI) between groups (P=0.07), and no impact was noted on dietary variability (P=0.64). In addition, animals treated with rbST-Fast exhibited more frequent visits to feeders, longer time in consumption, and higher relative DMI (per percentage of live weight) (P&lt;0.01). Animals in the rbST-Fast group produced more milk than those in the rbST-Later group (P=0.03). Furthermore, the weight of the cows was significantly different (P=0.05) between groups. The weight of the rbST-Fast animals was smaller and varied more than thot of the rbST-Later animals (P &lt;0.01). Nonetheless, no difference was noted in BCS (P=0.30) between the groups. The animals in the rbST-Fast group had higher concentrations of NEFA than those in the rbST-Later group (P&lt;0.01). In conclusion, behavioral and metabolic shifts that sustained greater milk production in the cows receiving rbST-Fast. Nonetheless, these shifts are likely linked to lipomobilization and not dietary variability or consumption, as evidenced by the increase in NEFA and greater weight loss in that group.