Low Intensity Research Articles

Maternal cigarette smoking before or during pregnancy increases the risk of severe neonatal morbidity after delivery: a nationwide population-based retrospective cohort study

BackgroundThe association of maternal cigarette smoking during pregnancy with severe neonatal morbidity (SNM) is still inconclusive. We aimed to examine the associations of the timing and the intensity of maternal...

Hierarchical Biclustering of Mouse Pancreas Mass Spectrometry Imaging Data Using Recursive Rank-2 Non-negative Matrix Factorization.

One of the main challenges in mass spectrometry imaging data analysis remains the analysis of m/z-spectra displaying a low signal-to-noise ratio caused by their low abundance, sample preparation, matrix effects, fragmentation, and other artifacts. Additionally, we observe that molecules with a high abundance suppress those with lower intensities and misdirect classical tools for MSI data analysis, such as principal component analysis. As a result, the observed significance of a molecule may not always be directly related to its abundance. In this work, we present a recursive rank-2 non-negative matrix factorization (rr2-NMF) algorithm that automatically returns spectral and spatial visualization of colocalized molecules, both highly and lowly abundant. Using this hierarchical decomposition, our method finds spatial and spectral correlations on different levels of abundances. The quality of the analysis is evaluated on MALDI-TOF data of healthy mouse pancreatic tissue for the annotation of molecules of interest in the lower abundances. The results show interesting findings regarding the functioning and colocalization of certain molecules.

Growth, phytochemical, and phytohormonal responses of basil to different light durations and intensities under constant daily light integral

Horticulture in controlled environments has been increasingly used to tackle limitations on crop production. As a crucial environmental factor, light regulate plant growth and metabolism. In the present study, basil plants were subjected to different light durations and intensities considering constant daily light integral (DLI). The lighting environment included 200, 300, and 400 µmol m− 2 s− 1 intensities for 18, 12, and 9 h, respectively. DLI amounted to 12.96 mol m− 2 d− 1 among all light treatments (LI200 for 18 h, LI300 for 12 h, and LI400 for 9 h). Half of the plants under each light treatment were exposed to 30 µmol m− 2 s− 1 of far-red light. The results indicated the general negative impact of LI400/9 on the growth of basils. Exposure to far-red light hurt the growth of the shoot, while it enhanced stem and petiole elongation. This effect was due to higher gibberellin accumulation, which resulted in shade avoidance responses. Exposure to far-red light also reduced anthocyanin and flavonoid contents, as two important nutritional components. Soluble carbohydrates increased, while storage carbohydrates decreased by increasing lighting duration/decreasing light intensity or by far-red light inclusion. The lowest antioxidant activity was detected in LI400/9. In the LI200/18, the highest level of auxin and the lowest level of cytokinin were detected, while the LI300/12 exhibited the highest level of gibberellin hormone. Low light intensity and long photoperiod enhanced plant biomass and phytochemical production and are recommended for basil production in controlled environments.

Synergistic effect and role of light for efficient photothermocatalytic CO2 reduction by CH4 on Pd/Co-Al1Mg3Ox

Photothermocatalytic CO2 reduction by CH4 converts greenhouse gases into valuable syngas, but limited by high light intensity and carbon deposition. Here, we designed a nanocomposite supporting low content of Pd nanoparticles on Co and Al doped MgO (Pd/Co-Al1Mg3Ox), achieving high production rates of H2 (rH2, 73.04 mmol min−1 g−1) and CO (rCO, 84.80 mmol min−1 g−1) with light-to-fuel efficiency (η, 25.3 %) at relatively low light intensity (81.1 kW m−2). Compared to Pd/Al1Mg3Ox, Pd/Co-Al1Mg3Ox demonstrates improvements of rH2, rCO and η by 6.5, 6.2 and 6.7 times respectively with great durability of 48 hours. This originates from a synergetic effect between Pd and Co-Al1Mg3Ox that the participation of active oxygen from Co-Al1Mg3Ox greatly accelerates carbon species (C*) oxidation. Interestingly, light plays unique roles on Pd/Co-Al1Mg3Ox which not only expedites C* oxidation, activates the oxygen connected to Pd and Co-Al1Mg3Ox, but also reverses rapid thermocatalytic deactivation by boosting CO desorption.

The effect of different essential oils used in stoma bags of individuals with colostomy remooval of odor, life satisfaction and effect on stoma fit: Randomized controlled study

ObjectiveThe aim of the research was conducted as a randomized controlled interventional study to determine the effect of lavender/mint essential oils placed in stoma bags on odor removal, life satisfaction and stoma compliance in individuals with colostomy. MethodThe research population is patients with permanent colostomy registered in a university hospital's stoma therapy unit. The sample consisted of 60 (20 lavender oil, 20 peppermint oil, 20 control group) patients who met the sampling criteria and voluntarily agreed to participate in the study. In the evaluation of the data the 'Numerical Evaluation Scale' (NES), the 'Satisfaction with Life Scale (SLS), and the 'Ostomy Adjustment Scale' (OAS-23) were used. ResultsThe lavender oil and peppermint oil groups had lower mean odor intensity, mean scores, higher life satisfaction, and stoma compliance scores than the control group. A statistically significant difference was found between the groups (p<0.05). In comparisons made within the groups, statistically, significant differences were found in the mean scores of odor intensity level, life satisfaction, and stoma compliance after the process (p<0.05). ConclusionIt was determined that lavender/peppermint oil placed in the stoma bag in patients with colostomy decreased the level of odor intensity, and increased life satisfaction, and stoma compliance. The trial was registered in the Clinical Trial (ClinicalTrials.gov ID: NCT05716711

Dynamic annealing assisted near-surface structural and bond stabilization in high-temperature low-energy N2+ implanted diamond.

Nitrogen-rich ultra-thin (1-2nm thick) layers in diamond produced by high-temperature nitrogen ion (N2+) implantation at low N2+ energies studied by in situ x-ray photoelectron spectroscopy are reported. Nitrogen bonding at the subsurface region and its thermal stability, as well as structural defects in polycrystalline diamond (PCD) implanted with 200, 500, and 800eV N2+ at room temperature (RT) and 600 °C at an ion dose of 4.5 × 1014 ions/cm2, are investigated. Implantation at RT leads to nitrogen bonding at interstitial and substitutional sites in the diamond lattice, which is associated with the C-N/C=N bond, lower intensity of the C≡N (nitrile-like) component associated with nitrogen bonding with carbon defects, and quaternary nitrogen. The relative composition of these chemical states varies with implantation energy, temperature, and post-implantation annealing temperature. Upon annealing the RT implanted layers above 500-600 °C, the interstitial nitrogen converts to substitutional nitrogen. This process competes with nitrogen desorption. The thermal stability of nitrogen increases with implantation energy. Implantation at 600 °C at 800eV resulted in a significantly lower concentration of nitrile-like bonds and a lower density of structural defects compared to RT implantation at the same energy. These effects are associated with dynamic annealing, which becomes more significant at higher implantation energies. Upon high-temperature implantation, nitrogen mostly populates directly substitutional sites. Nitrogen implantation at low energy and high temperature may be a viable way to nitride diamond surfaces with reduced density of defects where nitrogen is selectively bonded to substitutional sites. Finally, a comparison between nitrogen implantation into PCD and Diamond (100) [Di(100)] surfaces is presented.

Secondary prophylaxis of venous thromboembolism (VTE) with low dose apixaban or rivaroxaban in major-thrombophilia carriers.

Direct oral anticoagulants (DOACs) are widely used for treatment and secondary prophylaxis of venous thromboembolism (VTE) and represent the gold standard for VTE secondary prophylaxis, with low-intensity DOACs administration becoming increasingly used worldwide in such scenario. Albeit widespread DOACs usage there are few literature data regarding their efficacy and safety in major thrombophilia carriers and almost no data is available for low intensity apixaban and rivaroxaban as secondary VTE prophylaxis in such patients. The aim of our study is to evaluate and confront the efficacy and safety of low-dose DOACs for VTE secondary prophylaxis, in major thrombophilia carriers vs patients at high risk of VTE recurrence for other reasons. We retrospectively evaluated patients who required long-term anticoagulant secondary prophylaxis to prevent recurrent VTE, treated with apixaban 2.5mg BID or rivaroxaban 10mg daily and that were screened for thrombophilia. The examined patients were 339. Baseline characteristics such as sex, age, obesity rate, smoking, number of previous VTEs and comorbidities (such as cardiovascular diseases, diabetes, mild CKD) were equally distributed in either group. The median low-dose DOACs administration time was 19.20months (IQR 12.17-35.67). During low-dose DOACs treatment, 13 (3.8%) VTE recurrences were observed; 14 bleeding events were registered (4,1%), with no major bleeding (MB), 6 clinically relevant non major bleeding (CRNMB) (1.8%) and 8 minor bleeding (2.3%). No statistically significant difference in the rate of VTE recurrence and/or bleeding events emerged between major thrombophilia carriers and non-major thrombophilia carriers. In multivariate analysis increased risk of VTE recurrence was found for patients with cardiovascular comorbidities (HR 4.00 - p = 0.034) and for patients with more than one previous VTE episode (HR 5.14-p = 0.034). Our data suggest that low-dose DOACs may be effective and safe in secondary VTE prophylaxis for carriers of major thrombophilia with no increase in VTE recurrence and/or bleeding risk.

Enhanced Method for Localization of Partial Discharges in Oil-Filled Transformers Using Acoustic Emission Signals

The accurate measurement of partial discharges (PD) in power transformers is a critical component in identifying faults and planning effective maintenance strategies. Acoustic emission (AE) sensing technology is suitable for detecting partial discharges in transformers because it is less affected by external electromagnetic interference and detects PD non-invasively. This paper delves into examining the relationship between the detection intensity, the specific type of PD source, and the distance to the discharge source, using AE sensors. It was observed that AE wave intensities from corona discharges tend to be relatively strong, indicating a higher detection probability. Creepage discharges usually exhibit the next level of intensity, followed by the PD occurring in bubbles. It is considered that the intensity of the AE waves varies significantly depending on both the speed at which the discharge propagates and the medium and volume of the discharge space. Furthermore, this study has conducted experimental comparisons among three distinct methods for calculating the Time Difference of Arrival (TDOA) in localization calculations. These methods are the energy criterion, Generalized Cross-Correlation (GCC), and GCC with Phase Transformation (PHAT). The experimental results suggest that the energy criterion method is particularly effective when sensors are distributed placement around the entire tank. In contrast, the GCC-PHAT method shows greater suitability in scenarios where sensors are centralized placement in certain sections of the tank. It was clearly observed that the GCC-PHAT method, which suppresses the impact of noise and reflections, consistently achieves higher estimation accuracy in comparison to the standard GCC method. Notably, this method has shown the ability to maintain its accuracy levels even in cases of low discharge intensities. The implications of these findings are significant, as they could improve the precision and effectiveness of maintenance diagnostics in power transformers.

Extensive Genomic Rearrangement of Catalase-Less Cyanobloom-Forming Microcystis aeruginosa in Freshwater Ecosystems.

Many of the world's freshwater ecosystems suffer from cyanobacteria-mediated blooms and their toxins. However, a mechanistic understanding of why and how Microcystis aeruginosa dominates over other freshwater cyanobacteria during warmer summers is lacking. This paper utilizes comparative genomics with other cyanobacteria and literature reviews to predict the gene functions and genomic architectures of M. aeruginosa based on complete genomes. The primary aim is to understand this species' survival and competitive strategies in warmer freshwater environments. M. aeruginosa strains exhibiting a high proportion of insertion sequences (~ 11%) possess genomic structures with low synteny across different strains. This indicates the occurrence of extensive genomic rearrangements and the presence of many possible diverse genotypes that result in greater population heterogeneities than those in other cyanobacteria in order to increase survivability during rapidly changing and threatening environmental challenges. Catalase-less M. aeruginosa strains are even vulnerable to low light intensity in freshwater environments with strong ultraviolet radiation. However, they can continuously grow with the help of various defense genes (e.g., egtBD, cruA, and mysABCD) and associated bacteria. The strong defense strategies against biological threats (e.g., antagonistic bacteria, protozoa, and cyanophages) are attributed to dense exopolysaccharide (EPS)-mediated aggregate formation with efficient buoyancy and the secondary metabolites of M. aeruginosa cells. Our review with extensive genome analysis suggests that the ecological vulnerability of M. aeruginosa cells can be overcome by diverse genotypes, secondary defense metabolites, reinforced EPS, and associated bacteria.

Evaluating Driver Response to Bridge Deck Warning Systems During Winter Weather Conditions

Warning signs are often deployed at bridge overpasses during winter to warn motorists of potentially icy surface conditions on the bridge, although the effectiveness of these signs is questionable. One potential improvement to the standard signage methods is the bridge deck warning system (BDWS), which activates a flashing warning sign border or beacon when conditions warrant based on real-time weather and bridge surface data. However, BDWSs have not been broadly implemented in the United States, and consequently, their effectiveness as a safety countermeasure is not well established. To address this knowledge gap, a series of winter field evaluations were performed along three freeway bridge overpasses in Michigan to assess the effectiveness of various BDWS strategies as a speed reduction countermeasure for motorists approaching a potentially icy bridge. The results showed that a BDWS with a flashing light emitting diode (LED) border reduced motorist speeds when encountering a bridge during winter weather conditions compared with the standard “Bridge Ices Before Road” warning sign. The speed reduction effect was consistent between passenger cars and heavy trucks, but was somewhat stronger at night compared with daytime. Greater speed reductions were observed when the BDWS sign was combined with a dynamic speed feedback sign (DSFS) that displayed a “Slow Down” or “Icy Road” message to approaching motorists, with the strongest effects observed when the DSFS message was pulsed between high and low brightness intensities. BDWSs that included only a flashing overhead beacon did not have a significant effect on speeds compared with the standard warning sign.

Perceptual sensitivity to labeling stereotyped emotion expressions: Associations with age and subclinical psychopathology symptoms from childhood through early adulthood.

This study investigates (a) age-related differences in how the intensity of stereotyped facial expressions influence the emotion label children, adolescents, and adults assign to that face and (b) how this perceptual sensitivity relates to subclinical symptoms of psychopathology. In 2015-2016, 184 participants aged 4-25 years viewed posed stereotypes of angry, fearful, sad, and happy expressions morphed with neutral expressions at 10%-90% intensity. Thin plate regression smoothing splines were used to chart nonlinear associations between age and the perceptual threshold participants needed to assign the emotion label expected based on cultural consensus. Results suggest that sensitivity to labeling stereotypical happy faces as "happy" peaked by age 4. Sensitivity to perceiving stereotypical angry faces as "angry" increased from ages 4 to 7 and then plateaued. In contrast, sensitivity to perceiving stereotypical fearful and sad faces demonstrated protracted development, not reaching a plateau until ages 15 and 16, respectively. Reduction in selecting the "I don't know" response was the primary driver of these age-related changes. Stereotyped fear expressions required the highest intensity to be labeled as such and showed the most marked change in perceptual threshold across development. Interestingly, lower intensity morphs of stereotypical fear faces were frequently labeled "sad." Furthermore, perceiving lower intensity fear morphs was associated with fewer internalizing and externalizing symptoms in participants aged 7-19. This study describes the development of perceptual sensitivity to labeling stereotypical expressions of emotion according to cultural consensus and shows that how people perceive and categorize ambiguous facial expressions is associated with vulnerability to psychopathology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Pulse length effects in the nonresonant long-wave infrared nonlinear optical response of n-Ge, GaAs, and ZnSe

Nonlinear optical refraction and nonlinear absorption are characterized in important long-wave infrared optical materials with picosecond and femtosecond laser pulses. The effective nonlinear refractive indices are found to be constant across a range of pulse parameters. Nonlinear absorption far from resonance is observed at relatively low (∼1GW/cm2) intensities in these materials, and the onset intensity and fluence scale strongly with pulse length. A free carrier dominated nonlinear absorption mechanism is identified for picosecond pulses, whereas nonperturbative photoionization causes femtosecond absorption.

Early Postoperative Pain Course following Primary and Secondary Targeted Muscle Reinnervation: A Temporal Description of Pain Outcomes.

Targeted muscle reinnervation (TMR) is an effective surgical treatment of neuropathic pain for amputees. However, limited data exist regarding the early postoperative pain course for patients who undergo either primary (<14 days since amputation) or secondary (≥14 days) TMR. This study aims to outline the postoperative pain course for primary and secondary TMR during the first 6 postoperative months to aid in patient education and expectation management. Patients were eligible if they underwent TMR surgery between 2017 and 2023. Prospectively collected patient-reported outcome measures of pain scores, Pain Interference, and Pain Intensity were analyzed. Multilevel mixed-effects models were utilized to visualize and compare pain courses between primary and secondary TMR patients. A total of 203 amputees were included, with 40.9% being primary and 59.1% being secondary TMR patients. Primary TMR patients reported significantly lower pain scores over the full 6-month postoperative trajectory (p < 0.001) compared with secondary TMR patients, with a difference of Δ -1.0 at the day of TMR (primary = 4.5, secondary = 5.5), and a difference of Δ -1.4 at the 6-month mark (primary = 3.6, secondary = 5.0). Primary TMR patients also reported significantly lower Pain Interference (p < 0.001) and Pain Intensity scores (p < 0.001) over the complete trajectory of their care. Primary TMR patients report lower pain during the first 6 months postoperatively compared with secondary TMR patients. This may reflect how pre-existing neuropathic pain is more challenging to mitigate through peripheral nerve surgery. The current trends may assist in both understanding the postoperative pain course and managing patient expectations following TMR. Therapeutic - IV.

Encapsulation of Curcumin With Persian Gum and Its Application to the Production of Functional Yogurt: Physicochemical, Antioxidant, Sensory Properties, and Starter Bacteria Survival Study

ABSTRACTThis study aimed to evaluate the ability of Persian gum to encapsulate curcumin and enhance its stability in dairy products. Given the increasing interest in functional foods, this study investigated the incorporation of nanocapsules containing curcumin (CLN) into functional stirred yogurt (CLN‐Y). CLN was prepared with Persian gum (PG) at different levels and included in the yogurt formula (CLN‐Y1%, CLN‐Y2%, and CLN‐Y3%). The physicochemical properties, rheological characteristics, antioxidant activity (AA), survival of starter bacteria, and sensory properties of the yogurt were evaluated over a 21‐day storage period at 4°C. The results showed that CLN significantly improved AA (reduction of 7.31% in the control vs. 1.85% in CLN‐Y3%), viscosity, hardness, and water holding capacity (reduction of 2.27% in control vs. 1.14% in CLN‐Y3%), while reducing syneresis (an increase of 10.87% in control vs. 3.16% in CLN‐Y3%) during storage (p &lt; 0.05). CLN concentration directly affected AA. Although CLN‐Y exhibited a yellowish color and lower light intensity than the control, the samples were well accepted during storage. Increasing CLN levels led to decreased taste, color, and overall acceptance scores, and a 3% concentration is recommended for yogurt formulation due to its potential to improve yogurt quality, provide antioxidant benefits, maintain probiotic viability, and achieve high consumer acceptance during storage.

Photophysiological response of glacier ice algae to abiotic stressors

The glacier ice algae Ancylonema alaskanum and Ancylonema nordenskiöldii grow in harsh dynamic environments on bare ice surfaces. In these environments, they contribute to the continuous darkening of the ice surface, which in turn accelerates the ice melt. However, investigation into their adaptation and resilience in these environments is necessary in order to understand their robustness and potential for increasing the intensity of blooms. In this study, it was examined how variations in environmental parameters such as pH, salinity, light and temperature impacted the photophysiology of the glacier ice algae during a bloom in Greenland. Through in situ incubations and pulse-amplitude-modulation (PAM) fluorometric measurements, the photophysiological responses of algal cells were assessed. Results suggest that light intensity significantly influences glacier ice algae photophysiology, with cells exhibiting better performance (in terms of a higher theoretical maximum light coefficient and maximum quantum efficiency) under lower light intensity. Moreover, while light emerges as the primary driver of photophysiology, glacier ice algae demonstrate tolerance to a broad range of pH and temperatures four times higher than those experienced during Greenland’s summer.

Temporal Dynamics of Pain: Examining the Relationship Between Intramuscular Injection Duration and Pain Perception: A Crossover Randomized Controlled Trial.

Background Effective pain management is crucial for optimizing the patient experience and satisfaction with care. Many factors affect the intensity of injection pain, and one of these factors is the duration of the injection. This study aimed to evaluate the impact of intramuscular injection duration on perceived pain intensity in adults. Methods Fifty participants received injections according to a predetermined research protocol. Each participant served as their own control group. The intervention group was administered the drug over 40 seconds. The control group was given the same drug on the other side dorsogluteal region the following day, according to the unit's routine, in 10 seconds. Pain intensity was measured using the Wong-Baker Faces Pain Rating Scale and the Numerical Rating Scale. Statistical analysis was performed using SPSS (IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp), including Wilcoxon and correlation analyses, with a significance level set at p < 0.05. Results The Wilcoxon test revealed a significant decrease in pain scores for the intervention group (p < 0.05), indicating that longer injection durations were associated with lower pain intensity. Significant correlations were found between hospital phobia and the use of pain relief measures, with pain perception (p < 0.05). Conclusion This research establishes a correlation between extended durations of intramuscular injections and pain intensity. These findings have implications for pain management during medical procedures and can contribute to optimizing patient comfort.

CH4 and CO2 Reductions from Methanol Production Using Municipal Solid Waste Gasification with Hydrogen Enhancement

This study evaluates the greenhouse gas (GHG) impacts of converting municipal solid waste (MSW) into methanol, focusing on both landfill methane (CH4) emission avoidance and the provision of cleaner liquid fuels with lower carbon intensity. We conduct a life cycle assessment (LCA) to assess potential GHG reductions from MSW gasification to methanol, enhanced with hydrogen produced via natural gas pyrolysis or water electrolysis. Hydrogen enhancement effectively doubles the methanol yield from a given amount of MSW. Special attention is given to hydrogen production through natural gas pyrolysis due to its potential for lower-cost hydrogen and reduced reliance on renewable electricity compared to electrolytic hydrogen. Our analysis uses a case study of methanol production from an oxygen-fired entrained flow gasifier fed with refuse-derived fuel (RDF) simulated in Aspen HYSYS. The LCA incorporates the significant impact of landfill methane avoidance, particularly when considering the 20-year global warming potential (GWP). Based on the LCA, the process has illustrative net GHG emissions of 183 and 709 kgCO2e/t MeOH using renewable electricity for electrolytic hydrogen and pyrolytic hydrogen, respectively, for the 100-year GWP. The net GHG emissions using 20-year GWP are −1222 and −434 kgCO2e/t MeOH, respectively. Additionally, we analyze the sensitivity of net GHG emissions to varying levels of fugitive methane emissions.

8785 Does Somatostatin Receptor Expression Intensity Impact Prognosis in Non Pituitary Neuroendocrine Tumors Treated with Somatostatin Analogues?

Abstract Disclosure: N. Saleh Jouneghani: None. S. Fazeli: None. S. Chang: None. A. Hosseini: None. R. Marandi: None. A. Siddiqui: None. M. Talley: None. B. Salehian: None. Does Somatostatin Receptor Expression Intensity Impact Prognosis in Non Pituitary Neuroendocrine Tumors Treated with Somatostatin Analogues? Introduction: Non-pituitary neuroendocrine tumors (NETs) show different somatostatin receptor subtype (SSTR) expression, but their role in tumor progression and prognosis is not well known. We hypothesized that NETs with higher expression of SSTR2, SSRT5, or co-expression of SSTR2 and SSTR5 will have better outcome when treated with Somatostatin Analogues (SSA). Method: Retrospectively, patients with non-pituitary neuroendocrine tumors, followed for more than one year between 1985 and 2022, and treated with SSA (Octreotide or Lanreotide) who had available tissue were selected. Tissue immunostaining performed for SSTR2 and SSTR5 with use of monoclonal antibodies. Expression analysis of the SSTR2 and SSTR5 were evaluated by the validated semi-quantitatively method, reported by an intensity score of 0 -3. The progression free survival and overall survival were calculated by Kaplan Meier and compared in different subgroups with SSTR expression intensity. Response evaluation was assessed using RECIST v1.1. Results: Of 279 non-pituitary neuroendocrine tumors, 51 meet the criteria and tissue sent for analysis. The median age at diagnosis was 62; male 49%, with median follow up 7 years, 85% stage IV at diagnosis, most common primary tumor was in gut 54% followed by pancreas 33%. Positive SSRT5 tumors had 93% SSRT2 co-expression. There were no significant differences in progression-free survival (PFS) observed between tumors with low or high SSTR2 intensity expression (P=0.62). The presence or absences of SSRT5 expression did not have any impact on PFS (p=0.57) or overall survival (p=0.3). Conclusion: in the patient with non-pituitary neuroendocrine tumors, higher SSTR2 expression intensity or having SSRT5 co-expression, did not correlate with a better PFS or overall survival in response to SSA, in our study. Further prospective studies are needed to clarify if higher expression intensity of SSRTs correlates with better response to SSAs in NETs. Presentation: 6/1/2024

6485 Unilateral Adrenal Metastasis From Unknown Primary Carcinoma Mimicking Primary Adrenocortical Carcinoma

Abstract Disclosure: S. Watanabe: None. S. Suzuki: None. K. Ishiwata: None. Y. Yamazaki: None. H. Sasano: None. K. Yokote: None. Background: Adrenal metastasis from carcinomas of the lung, breast, and melanoma are observed. However, isolated adrenal metastasis with unknown primary carcinoma origin has been rare, and the diagnosis is challenging. We encountered a case of unilateral adrenal tumor clinically diagnosed as non-functional primary adrenocortical carcinoma, but found to be a metastatic tumor on postoperative pathology. Clinical Case: A 68-year-old man was referred to our hospital for examination of an 8mm right adrenal incidentaloma. He underwent hormone therapy for prostate cancer four years ago, and the condition is in remission with no recurrence signs. Follow-up CT revealed that the adrenal tumor rapidly enlarged from 8 mm to 36 mm within six months, and its mean attenuation value was 38 HU. MRI showed that the adrenal tumor had a low signal intensity on T1 and a high signal on T2. At the same time, there is mediastinal lymphadenopathy and a 9-mm nodule in the lower lobe of the right lung, which was considered benign from the stable condition. FDG-PET/CT showed FDG uptake only in the right adrenal tumor (maximum standardized uptake value of 21.39). [1]23I-MIBG scintigraphy did not show any accumulations. The serum and urinary adrenal hormones were all within normal limits. Notably, tumor markers such as prostate-specific antigen (PSA), carcinoembryonic antigen (CEA), α-fetoprotein (AFP), and cancer antigen 19-9 (CA 19-9) were all within normal ranges. Therefore, we clinically suspected non-functional primary adrenocortical carcinoma, and the laparoscopic right adrenalectomy was performed. The resected right adrenal lesion was encapsulated and measured 79×54×22 mm. On histological analysis, the nodule comprised tumor cells with eosinophilic cytoplasm, and abundant tissue infiltrating lymphocytes. Immunohistochemical studies revealed that the tumor was not of adrenal origin due to negative steroidogenic factor-1 (SF-1) and inhibin alpha staining. From these results, the adrenal tumor was diagnosed as adrenal metastasis from unknown primary carcinoma. The tumor cells were positive for cytokeratin19, CEA, and thyroid transcription factor-1 but negative for PSA, p63, cytokeratin 5/6, insulinoma-associated protein-1, and synaptophysin. Genetically, the adrenal tumor harbored genomic abnormalities in CDKN2A, TP53, NF1, PBRM1, and KEAP1 genes. Conclusion: Isolated adrenal metastasis without a detectable primary tumor is rare but should be considered a differential diagnosis in the case of an enlarged, non-functioning adrenal tumor. Adrenalectomy or tumor biopsy may be actively considered to diagnose and determine the optimal course of treatment. Presentation: 6/3/2024

Effectiveness of pulpotomy in managing carious exposure in mature permanent teeth: A systematic review and meta-analysis

ObjectivesThis quantitative systematic review evaluated whether pulpotomy performed with hydraulic calcium silicate cements may be used as an alternative to root canal treatment (RCT) in mature permanent teeth with carious pulp exposure. Data sourcesA comprehensive search was conducted in PubMed, Web of Science, Scopus, and the Cochrane Library. No language restrictions were applied. The search included randomised controlled trials that compared pulpotomy to root canal treatment for managing carious exposure in mature permanent teeth. Study selectionStudies were selected based on predetermined inclusion criteria: randomised controlled trials involving mature permanent teeth with carious pulp exposure, using hydraulic calcium silicate cements for pulpotomy. Non-comparative studies, case reports, and trials involving primary or immature permanent teeth were excluded. DataData were extracted on success rates, clinical outcomes, follow-up periods, pain profiles, and potential complications. A meta-analysis was performed, revealing no statistically significant differences in success rates between pulpotomy and RCT. Both interventions demonstrated success rates exceeding 90 % at one-year and two-year follow-up periods. Pain profiles consistently showed lower post-operative pain intensity in the pulpotomy group compared to the RCT group during the first week. Potential complications, such as non-responsive pulp and difficulties in determining pulp vitality, were reported more frequently in the pulpotomy group. ConclusionsPulpotomy with bioactive hydraulic calcium silicate cements shows comparable success rates to RCT in managing carious pulp exposure in mature permanent teeth. The results suggest pulpotomy as a viable, less invasive alternative to RCT, particularly in cases where preservation of pulp vitality is paramount. Clinical significanceThis systematic review highlights pulpotomy as a less invasive and cost-effective alternative to root canal treatment in mature permanent teeth. With comparable success rates and lower post-operative pain, pulpotomy offers a promising approach to managing carious exposure and preserving tooth vitality.