PM Group Research Articles

Proteomic profiling of gastric cancer with peritoneal metastasis identifies a protein signature associated with immune microenvironment and patient outcome

BackgroundPeritoneal metastasis (PM) frequently occurs in patients with gastric cancer (GC) and is a major cause of mortality. Risk stratification for PM can optimize decision making in GC treatment.MethodsA total of 25 GC patients (13 with synchronous, 6 with metachronous PM and 6 PM-free) were included in this study. Quantitative proteomics by high-depth tandem mass tags labeling and whole-exome sequencing were conducted in primary GC and PM samples. Proteomic signature and prognostic model were established by machine learning algorithms in PM and PM-free GC, then validated in two external cohorts. Tumor-infiltrating immune cells in GC were analyzed by CIBERSORT.ResultsHeterogeneity between paired primary and PM samples was observed at both genomic and proteomic levels. Compared to primary GC, proteome of PM samples was enriched in RNA binding and extracellular exosomes. 641 differently expressed proteins (DEPs) between primary GC of PM group and PM-free group were screened, which were enriched in extracellular exosome and cell adhesion pathways. Subsequently, a ten-protein signature was derived based on DEPs by machine learning. This signature was significantly associated with patient prognosis in internal cohort and two external proteomic datasets of diffuse and mixed type GC. Tumor-infiltrating immune cell analysis showed that the signature was associated with immune microenvironment of GC.ConclusionsWe characterized proteomic features that were informative for PM progression of GC. A protein signature associated with immune microenvironment and patient outcome was derived, and it could guide risk stratification and individualized treatment.

A Mixture of Artemisia argyi and Saururus chinensis Improves PM2.5-Induced Cognitive Dysfunction by Regulating Oxidative Stress and Inflammatory Response in the Lung and Brain.

This study was performed to investigate the improving effect of a mixture of Artemisia argyi and Saururus chinensis (AASC) on cognitive dysfunction in mice with long-term exposure to fine particles (particulate matter smaller than 2.5 µm: PM2.5). The main compounds of AASC were identified as dicaffeoylquinic acid isomers of A. argyi and a quercetin-3-glucoside of S. chinesis. As a result of behavioral tests for the evaluation of cognitive function, it was confirmed that cognitive dysfunction was induced in the PM2.5 exposure group, and a tendency to improve in the AASC group was confirmed. Increased oxidative stress and inflammatory response and mitochondrial dysfunction were observed in the brain and lung tissues of the PM group. Damage to the brain and lung affected the accumulation of amyloid beta (Aβ) in the brain. It increased Aβ and induced the cholinergic dysfunction, hyperphosphorylation of the tau protein, and activation of apoptosis, leading to cognitive impairment. However, AASC suppressed brain and lung oxidative stress and inflammation, thereby suppressing brain Aβ expression. Consequently, this study shows the potential that a steady intake of plant resources with antioxidant and anti-inflammatory activity could prevent cognitive impairment caused by PM2.5.

Effects of dietary yeast hydrolysate on the growth performance, intestine health and digestion of juvenile yellow catfish (Pelteobagrus vachelli ♂ × Pelteobagrus fulvidraco ♀)

The effects of dietary yeast hydrolysate on the growth performance, gut health, and digestion of juvenile yellow catfish were evaluated throughout a 62-day feeding trial. Isonitrogenous and isoenergetic experimental diets were prepared. The positive control fishmeal (FM) diet contained 40 % FM. The negative control plant protein diet (PM group) contained 18 % soybean meal (SBM) and 18 % rapeseed meal (RSM). In other two test diets, 1 % and 5 % of yeast hydrolysate (1 % YH and 5 % YH group) were used to replace SBM and RSM (1:1) of PM group, respectively. The results showed no significant differences in the growth performance of yellow catfish among all groups. However, daily food intake was significantly increased in 5 % YH compared with the control PM. Besides, the apparent digestibility coefficient (ADC) of dry matter improved in 1 % YH, compared with FM. And the YH groups had significantly higher total EAA concentrations in plasma than PM group. The 1 %−5 % YH supplement in plant protein diet could improve the length of gut villi and density of distal intestinal microvilli, and enhance the antioxidant capacity of mid intestine and distal intestine. Compared with PM, YH groups increased the digestive capacity of proximal intestine and mid intestine. It is concluded that 1 %−5 % of dietary yeast hydrolysate improved intestine health, food consumption and absorptive ability of yellow catfish.

Sows’ pre- and post-crate opening behaviour in farrowing pens with different opening times

The aim of the present study was to investigate the sows’ behaviour in farrowing pens with a short-term fixation of five days around birth and the influence of the reproductive outcome. It was hypothesised that opening the farrowing crate in the evening may result in calmer sows due to less disturbance by stockpersons and thereby fewer dangerous posture changes of the sow and fewer piglet losses. The study focused on the pre- and post-crate opening behaviour of the sows expressed in lying down and rolling behaviour. Farrowing crates were opened three days post partum in the morning at 06.00 am (AM: n = 16) or in the evening at 06.00 pm (PM: n = 16). A further division was undertaken for sows with low (LR: n = 16) and high (HR: n = 16) rolling behaviour in the post-opening period. Video sequences of 72 h, divided into 24 h before and 48 h after the farrowing crate was opened were recorded continuously (to observe behaviour) and analysed using two event sampling methods: The frequencies of the lying down and rolling behaviour of the sows were documented as point events while the sows’ time budget (standing, sitting, lying) and the piglets’ positions during the sows’ lying down and rolling were documented as state events. The results show that rolling behaviour was performed less when the crate was opened in the evening compared to opening the crate in the morning (p = 0.08). Crushed piglets during lactation did not differ significantly between the groups but this tended to occur less frequently for PM grouped sows in the post-opening period. HR sows performed rolling more than twice as often as LR sows (p < 0.05) and showed significantly more frequent rolling from belly to side (p < 0.05). Furthermore, no significant difference was found for crushed piglets during lactation and both LR sows and HR sows crushed a similar number of piglets in the post-opening period. In both groups (AM, PM respectively LR, HR) the piglets’ positions were in the nest in more than 50% of the rolling events. In conclusion, crate opening in the evening resulted in less rolling movements, sows in the PM group tended to crush fewer piglets in the post-opening period compared to sows in the AM group. Opening the crate in the evening seems to be better, with the advantage that the animals are calmer and show less postural change due to an undisturbed environment after opening.

Resting coronary flow drives the daily pattern in coronary flow reserve in patients with chest pain without obstructive epicardial stenosis.

Ischemia with no obstructive coronary artery disease (INOCA) is a risk factor for major adverse cardiovascular events and is characterized by abnormal coronary microvascular tone. In patients with INOCA, adverse cardiovascular events most commonly occur in the morning compared to other times of the day and night. We tested whether coronary microvascular function varies diurnally with attenuation in the morning in patients with symptomatic coronary artery disease without significant (>50%) epicardial stenosis. We evaluated data from 17 patients studied in the AM (700-1159 h) and 11 patients in the PM (1200-1800 h). Coronary microvascular function was measured using perfusion contrast imaging at rest and after infusion of intravenous regadenoson. We calculated microvascular flow reserve as the ratio of hyperemic to resting flow. Along with independent sample t-tests, we performed bootstrapping procedures to test mean differences between AM and PM groups, using the bias-corrected and accelerated method with 5,000 bootstrapped samples. The AM and PM groups were matched for demographic and existing risk factors. Coronary microvascular flow reserve was ∼33% higher in the AM compared to the PM (P = 0.025, BCa 95% CI [0.25, 1.64]; Hedge's g = 0.89, 95% CI [0.11, 1.66]) as a result of significantly lower resting flow (∼50%) in the AM compared to the PM (P = 0.03, M Diff = -56.65, BCa 95% CI [-118.59, -2.12]; Hedge's g = -0.86, 95% CI [-1.60, -0.06]). Our observations are of clinical value and can influence diagnosis and treatment in the clinic based on the time of day of measurements.

Pulmonary microbiota intervention alleviates fine particulate matter-induced lung inflammation in broilers.

Fine particulate matter (PM2.5) released during the livestock industry endangers the respiratory health of animals. Our previous findings suggested that broilers exposed to PM2.5 exhibited lung inflammation and changes in the pulmonary microbiome. Therefore, this study was to investigate whether the pulmonary microbiota plays a causal role in the pathogenesis of PM2.5-induced lung inflammation. We first used antibiotics to establish a pulmonary microbiota intervention broiler model, which showed a significantly reduced total bacterial load in the lungs without affecting the microbiota composition or structure. Based on it, 45 AA broilers of similar body weight were randomly assigned to three groups: control (CON), PM2.5 (PM), and pulmonary microbiota intervention (ABX-PM). From 21 d of age, broilers in the ABX-PM group were intratracheally instilled with antibiotics once a day for 3 d. Meanwhile, broilers in the other two groups were simultaneously instilled with sterile saline. On 24 and 26 d of age, broilers in the PM and ABX-PM groups were intratracheally instilled with PM2.5 suspension to induce lung inflammation, and broilers in the CON group were simultaneously instilled with sterile saline. The lung histomorphology, inflammatory cytokines' expression levels, lung microbiome, and microbial growth conditions were analyzed to determine the effect of the pulmonary microbiota on PM2.5-induced lung inflammation. Broilers in the PM group showed lung histological injury, while broilers in the ABX-PM group had normal lung histomorphology. Furthermore, microbiota intervention significantly reduced mRNA expression levels of interleukin-1β, tumor necrosis factor-α, interleukin-6, interleukin-8, toll-like receptor 4 and nuclear factor kappa-B. PM2.5 induced significant changes in the β diversity and structure of the pulmonary microbiota in the PM group. However, no significant changes in microbiota structure were observed in the ABX-PM group. Moreover, the relative abundance of Enterococcus cecorum in the PM group was significantly higher than that in the CON and ABX-PM groups. And sterile bronchoalveolar lavage fluid from the PM group significantly promoted the growth of E. cecorum, indicating that PM2.5 altered the microbiota's growth condition. In conclusion, pulmonary microbiota can affect PM2.5-induced lung inflammation in broilers. PM2.5 can alter the bacterial growth environment and promote dysbiosis, potentially exacerbating inflammation.

Efficacy and safety of abatacept in patients with rheumatoid arthritis with previous malignancy.

Abatacept (ABT) is known to lower infection risk than other biologics and is effective and safe in elderly patients with rheumatoid arthritis (RA). However, there were inconsistent reports on the impact of ABT on malignancies which are more common in the elderly and strongly related to prognosis. This study aimed to evaluate the efficacy and safety of ABT in patients with RA with previous malignancy in clinical practice. A multicenter, retrospective study. Patients who received ABT for RA in two hospitals in Yokohama until May 2022 were included in this study. The patients were divided into two groups according to the presence or absence of a history of malignancy (no previous malignancy: NP group, previous malignancy: PM group). The collected parameters were compared between the groups using propensity score matching. In this study, 312 patients were included, of whom 73 had previous malignancies when starting ABT. The age at ABT initiation was significantly higher in the PM group, the rate of methotrexate use was significantly lower in the PM group, and the Steinbrocker stage was significantly higher in the PM group. After matching these 3 factors, 68 patients were selected from each group. No significant differences in the ABT continuation rate, and malignancy incidence were observed between the two groups after ABT initiation. In addition to these factors, when matched for smoking history, interstitial lung disease, disease duration, sex, and inflammatory status, which are known risk factors for malignancy in RA, 40 patients were selected from each group. No significant differences in the ABT continuation rate, and malignancy incidence were observed between the two groups after ABT initiation. In our clinical practice, ABT was as effective and safe in patients with a history of malignancy as in those without.

PS-C21-7: IMPACT OF THE TIME OF DAY PERFORMING AVS ON THE SUCCESS RATE AND SUBTYPE DIAGNOSIS IN PRIMARY ALDOSTERONISM

Purpose: Adrenal vein sampling (AVS) is the gold-standard technique for the subtype diagnosis of primary aldosteronism (PA). Measurements of aldosterone and cortisol in adrenal venous blood are used to determine the success or failure of AVS and to diagnose the PA subtype, but these hormone secretions show diurnal change. In this study, we examined the effect of the time of AVS on the results. Design: Multicenter, retrospective, observational study Setting: Three centers in Japan Patients: 591 patients diagnosed with PA and undergoing AVS at 3 centers were used. All patients underwent basal AVS and ACTH-stimulated AVS on the same day. 382 patients underwent AVS in the morning (AM-AVS) and 209 patients in the afternoon (PM-AVS). Results: In terms of Selectivity Index (SI) in AVS, there was no significant difference in the right adrenal vein in basal AVS (22 vs. 23, p = 0.26), but SI of AM-AVS group was significantly higher in the left adrenal vein (19 vs. 17, p = 0.03). 03) than PM-AVS. However, in AVS after ACTH loading, SIs of both right and left adrenal veins were significantly higher in the PM group (Right: 42 vs. 44, p = 0.03; Left: 48 vs. 50, p = 0.01). However, there was no significant difference in AVS success rates between the two groups for basal AVS (81% vs. 74%, p = 0.08) and ACTH-stimulated AVS (92% vs. 88%, p = 0.19). There was also no significant difference in the proportion of patients diagnosed with unilateral PA in basal AVS (57% vs. 48%, p = 0.09) and ACTH-stimulated AVS (17% vs. 14%, p = 0.41). Conclusions: In a multicenter observational study, there was no significant difference in AVS success rate or subtype diagnosis of AVS between the different AVS times.

Permanent pacing versus cardioneuroablation for cardioinhibitory vasovagal syncope.

We compared the efficacy and safety of cardioneuroablation (CNA) vs. permanent pacing (PM) for recurrent cardioinhibitory vasovagal syncope (CI-VVS). One hundred sixty-two patients (CNA = 61, PM = 101), age 36 + 11years) with syncope frequency of 6.7 ± 3.9/year were included in this multicenter study. All patients with CNA were provided by a single center, while patients with PM were provided by 4 other centers. In the CNA arm, an electroanatomic mapping guided approach was used to detect and ablate ganglionated plexus sites. Dual chamber rate drop response (RDR) or close loop stimulation (CLS) transvenous and leadless pacemakers were implanted using standard technique. The primary endpoint was freedom from syncope. Of 101 patients in the PM group, 39 received dual-chamber pacemaker implants with the CLS algorithm, 38 received dual-chamber pacemakers with the RDR algorithm, and 24 received a leadless pacemaker. At 1-year follow-up, 97% and 89% in the CNA and PM group met the primary endpoint (adjusted HR = 0.27, 95% CI 0.06-1.24, p = 0.09). No significant differences in adverse events were noted between groups. There was no significant association between age (HR:1.01, 95% CI 0.96-1.06, p = 0.655), sex (HR:1.15, 95% CI 0.38-3.51, p = 0.809), and syncope frequency in the past year (HR:1.10, 95% CI 0.97-1.25, p = 0.122) and the primary outcome in univariable analyses. After adjustment for patient characteristics, the medium-term syncope recurrence risk of CI-VVS patients who underwent CNA was similar to that of a population of patients undergoing pacemaker implantation with a similar safety profile.

Fluctuations in blood pressure measurement: the impact of time of day and ethnicity‐ A HABS‐HD Study

AbstractBackgroundVascular risks including hypertension are significant factors in the development of Alzheimer’s and related dementias . Multiple blood pressure (BP) measurements are commonly used in clinical and research practice to assess this vascular risk. Anecdotal evidence suggests that the first BP measurement taken is more elevated than the second measurement as a participant may be nervous about the study. This study explores if the first measurement is elevated compared to the second and then explores the differences between morning and afternoon measurements.MethodData from 1705 participants (non‐Hispanic Whites and Mexican Americans) was collected from a community‐based epidemiological study of aging. The average age was 66, and the average education was 12 years. Participants are scheduled either for AM or PM visit. BP measurements are taken post the consent and then after the participant interview prior to the start of neuropsychological testing. The systolic (SBP) and diastolic blood pressure (DBP) changes were calculated by subtracting the second measurement from the first. T‐tests were performed comparing AM to PM groups. Chi‐square tests compared ethnicity and cognitive status in the AM and PM groups. One‐way ANOVAs examined group differences (ethnicity and AM/PM draw groups) in BP measurement.ResultResults showed significant differences in SBP change between the AM (M = ‐0.52, SD = 12.74) and PM (M = ‐4.03, SD = 10.89); t(1666)= 6.07, p &lt; 0.000) draw and DBP change in the AM (M = 0.16, SD = 7.68) and PM (M = ‐2.32, SD = 6.68); t(1670)=7.09, p &lt;0.000). Chi‐square tests demonstrated significant differences between the AM and PM groups in ethnicity X2(1, N= 1705) = 33.27, p = 0.000. There were no significant differences between the AM and PM regarding cognitive status (normal, MCI, dementia). ANOVAs demonstrated significant differences between the groups in SBP change (F[3, 1672] = 12.76, p &lt;0.000) and DBP change (F[3, 1672] = 17.10, p &lt;0.000).ConclusionThe study results demonstrate that there was a relationship between BP and measurement time, which supports evaluating when BP measurements are taken and how this may affect outcomes. Future studies should examine how the blood pressure measurements relate to current guidelines.

The Efficacy of Same Day Plerixafor Dosing on CD34+ Haematopoietic Stem Cell Collection: A Single Centre Australian Experience

Introduction: Haematopoietic stem cell (HSC) transplantation is an important therapeutic option for many haematological conditions, as well as, some solid organ cancers. Plerixafor (a selective inhibitor of CXCR4) can be used in patients for primary stem cell mobilisation; those who have previously failed stem cell mobilisation ("rescue" or "Planned"); or in patients with a poor peripheral CD34+ response to GCSF and/or chemotherapy mobilisation ("on demand", "just in time" or "pre-emptive"). In Australia, Plerixafor is funded for patients with CD34+ count <10 cells/µl on day of collection or if first apheresis has yielded CD34+ <1 x 106cells/kg. In these patients, Plerixafor is administered the evening prior to the planned morning collection but this presents logistical issues as it has to be given after hours. Therefore, it was proposed to administer Plerixafor followed by same day HSC collection to improve the logistics of these "just in time" collections. Methods: A retrospective case note audit identified 96 patients who received Plerixafor for HSC collection between 03/2017 and 06/2021. Patients were categorised into PM (late afternoon/evening dosing) and AM (morning dosing). Transplant HSC dose target was >2 x 106/kg. Results: Of the 96 patients, 17 received 2 doses of plerixafor with 4 of these patients receiving both an AM and PM dose. These 4 patients were excluded from the final analysis. Of the 92 patients remaining, 57% (n=52) of patients received PM and 43% (n=40) AM dosing. Median age was 64 years (range 23 to 78). 58% were male (n=53) and 42% female (n=39). Underlying malignancy included Myeloma (n=51), Lymphoma (n=37) and Solid malignancy (n=4). Median pre plerixafor blood CD34+ count was 8.7x10^6/kg (range 0.3-35.5) in the PM group and 9.2 (range 1.6-38.2) in AM group prior to collection. Median number of HSCs collected post-plerixafor administration was 4.97 x106/kg (range 0.91-34.97) for PM group vs 4.16 x106/kg (range 0.71-9.52) AM group. Total median HSC number collected for patients in the PM group was 6.6x106cells/kg (range 3.14-8.18) vs 5.16x106/kg (range = 2.46-6.45) in the AM group. The AM group had an increased median HSC collected post plerixafor of 83% vs PM median of 75%. A transplantable HSC dose was collected in 97% of those in the AM group and 96% in the PM group. Median number of apheresis procedures with PM dosing was 2 (range 1-5) vs 2.4 with AM dosing (range 1-4). Conclusion: While post plerixafor HSC collection doses were higher with PM dosing this is countered by the total median HSC collection being higher in the AM group. These findings show that same day plerixafor dosing is a feasible option with similar numbers of patients achieving their target HSC collection.

Mizoribine halts kidney fibrosis in childhood IgA nephropathy: association with modulation of M2-type macrophages.

The immunosuppressant mizoribine (Miz) can reduce progression of childhood IgA nephropathy (IgAN). This study examined whether Miz affects CD163+ M2-type macrophages which are associated with kidney fibrosis in childhood IgAN. A retrospective cohort of 90 children with IgAN were divided into groups treated with prednisolone (PSL) alone (P group; n = 42) or PSL plus Miz (PM group; n = 48) for a 2-year period. Normal human monocyte-derived macrophages were stimulated with dexamethasone (Dex), or Dex plus Miz, and analyzed by DNA microarray. Clinical and histological findings at first biopsy were equivalent between patients entering the P and PM groups. Both treatments improved proteinuria and haematuria, and maintained normal kidney function over the 2-year course. The P group exhibited increased mesangial matrix expansion, increased glomerular segmental or global sclerosis, and increased interstitial fibrosis at 2-year biopsy; however, the PM group showed no progression of kidney fibrosis. These protective effects were associated with reduced numbers of glomerular and interstitial CD163+ macrophages in the PM versus P group. In cultured human macrophages, Dex induced upregulation of cytokines and growth factors, which was prevented by Miz. Miz also inhibited Dex-induced expression of CD300E, an activating receptor which can prevent monocyte apoptosis. CD300e expression by CD163+ macrophages was evident in the P group, which was reduced by Miz treatment. Miz halted the progression of kidney fibrosis in PSL-treated pediatric IgAN. This was associated with reduced CD163+ and CD163+CD300e+ macrophage populations, plus in vitro findings that Miz can suppress steroid-induced macrophage expression of pro-fibrotic molecules. A higher resolution version of the Graphical abstract is available as Supplementary information.

PSUN181 Diabetes-related outcomes following use of basal-bolus insulin vs. premixed insulin in a VA population with Type 2 diabetes: A retrospective chart review.

Abstract Background Treatment of diabetes mellitus (DM) with basal bolus insulin analogs (BB) requires up to five injections a day. The complexity of BB therapy may adversely influence patient compliance. A simpler and cheaper regimen with premixed insulin (PM) typically involves two injections a day but is perceived to be less effective in managing DM. The purpose of this research project was to compare DM-related outcomes between BB regimens (insulin detemir or glargine plus aspart, lispro or regular insulin) and PM insulin regimens (70/30 insulin NPH/regular) among our veteran population with type 2 DM. Research design and Methods This is a retrospective chart review that included 140 veterans (70 in BB group and 70 in PM group) with type2 DM. Subjects aged 18 years or above and those having A1C level ≥ 8% were included. Subjects with type 1 diabetes or who switched their insulin regimen during the follow-up period were excluded. The included subjects were followed for a year, after the start of respective insulin therapies to examine change in A1c (primary outcome) levels across groups. Data were analyzed using Chi-square/Fisher exact tests and logistic regression. All analyses were conducted using SPSS version 27 and SAS9.4. Results Out of 140 enrolled subjects, 94% were males with average age of 65.7 ± 10.1 years and DM duration of 12.9±9 years. There was no significant difference in age, gender, baseline A1c, BMI or duration of DM between the two groups. Following treatment initiation, there was no statistically significant difference between the BB and PM insulin groups for change in A1c (-1.9±1.8 vs -2.1±1.9%, p = 0.3) or for the rate of hypoglycemia (30% vs 21.4%, p = 0.3) respectively. Although the average BMI increased in both groups, the change was similar for both BB and PM groups (0.84±3.1 vs 0.4±2.2 kg/m2 respectively, p = 0.2). A logistic regression controlling for the confounders of hypoglycemia, found that the type of insulin used did not predict the development of hypoglycemia [OR 0.594, (0.251, 1.404)]. Conclusion There were no significant differences in A1c change, rate of hypoglycemia, and change in body mass index in patients treated with either BB or PM insulin among our study population. These results suggest that PM insulin is equally effective as the BB and its use can potentially improve patient compliance and reduce the cost of care. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

Clinical and radiologic outcomes of the modified phemister procedure with coracoclavicular ligament augmentation using mersilene tape versus hook plate fixation for acute acromioclavicular joint dislocation

BackgroundThe clinical superiority of surgical treatment for acromioclavicular (AC) joint dislocation remains controversial. The aim of this study was to compare the clinical and radiological outcomes of the modified Phemister procedure with CC ligament augmentation using Mersilene tape to those of hook plate fixation for acute AC joint dislocation.MethodsIn this study, patients who received modified Phemister surgery with CC ligament augmentation using Mersilene tape (PM group) or hook plate fixation (HK group) for acute unstable AC joint dislocation with a minimum 5-year follow-up period were retrospectively reviewed. The clinical outcomes were evaluated according to blood loss during surgery, surgical duration, visual analogue scale (VAS), Constant-Murley score (CMS), University of California at Los Angeles (UCLA) shoulder rating scale, and the occurrence of complications. Radiological outcomes were assessed from radiographs according to multiple parameters, including CC distance maintenance, acromion osteolysis, and the presence of distal clavicle osteolysis.ResultsA total of 35 patients completed follow-up for more than 5 years and were analyzed in this study (mean = 74.08 months). There were 18 patients in the PM group and 17 in the HK group. The PM group exhibited similar improvement in functional outcome to the HK group. Regarding radiological outcomes, the HK group had a superior performance in terms of CC distance maintenance, of statistical significance (CCDR: 94.29 ± 7.01% versus 111.00 ± 7.69%, p < 0.001) after a one-year follow-up period. However, there were 4 cases of acromion osteolysis and 2 cases of distal clavicle osteolysis in the HK group.ConclusionHook plate fixation was found to be superior to the modified Phemister technique with CC ligament augmentation using Mersilene tape in terms of CC distance maintenance, but there was no significant difference in the functional outcome after 5 years of follow-up. Both surgical methods are reliable options for the treatment of acute AC joint dislocation. Modified Phemister surgery with CC ligament augmentation using Mersilene tape is a relatively lower-cost option for acute AC joint dislocation without the need of a second surgery for implant removal.

The effect of water shower spray on stress physiology and mortality in broiler chickens subjected to road transportation under the hot and humid tropical condition.

This study was performed to investigate the effect of water shower spray on rectal temperature (RT), serum levels of corticosterone (CORT), heat shock protein (HSP) 70 and creatine kinase (CK) in broiler chickens road transported at different times of the day. A total of 320 male broiler chickens (35days of age) were crated and subjected to either water shower spray (WS) for 10min or no water shower (control). The WS and control broilers were then loaded into an open truck and transported either from 0900 to 1100h (29.0°C and 89.0% RH) (AM) or 1900h to 2100h (26.0°C and 94.0% RH) (PM) with an average speed of 80km/h. The CORT of AM birds were significantly reduced by WS, but the treatment had negligible influence on the PM group. Transportation during AM significantly elevated RT, CORT and HSP70 compared to the PM group. Water shower spraying of birds before transit significantly reduced RT and HSP70 compared to controls. Neither water shower treatment nor transportation time had a significant on CK and mortality rate of broilers. In conclusion, water shower spray is beneficial to alleviate the physiological stress response in road-transported broilers under the hot and humid tropical environment.

Do Concomitant Posterior Malleolus Fractures Affect Mid-Term Functional Outcomes in Tibial Shaft Fractures?

Category: Trauma; Ankle Introduction/Purpose: The association between diaphyseal tibial fractures and posterior malleolus fracture has been reported between 4 to 25% of cases. Early diagnosis requires a high level of suspicion and may change the surgical strategy. To our knowledge, no studies had compared the functional and quality of life results of tibial fractures with and without posterior malleolus extension. Methods: A retrospective comparative study including patients sustaining tibial shaft fractures classified by AO type 42, 43A, and 43B1.1, with a minimum one-year follow-up. Exclusion criteria included open fractures, pathological bone fractures and patients with a previous history of ipsilateral bone injury. Patients were divided into two groups, tibial shaft injuries with posterior malleolus fracture (PM) and fractures without posterior malleolus fracture (WPM) diagnosed using computed tomography (CT) preoperatively. The posterior malleolus fracture was fixed before the tibial fracture, either with 1 or 2 percutaneous anteroposterior or posteroanterior screws. Postoperative CT was used to assess the quality of reduction in all patients. Functional and quality of life results were evaluated using the Lower Extremity Function Score (LEFS), visual pain analog scale (VAS), and Short Form (SF12). We compared times of return to work/sports, complications and additional procedures during follow-up. Shapiro-Wilk test and Student t-test were used for statistical analysis. Results: Twenty patients in the PM group and 22 in the WPM group were included with a mean follow-up of 43 months (R:8-43). Groups were demographically comparable, with an average age of 47.6 and 43.3 years (p:0.34), respectively. All fractures healed, CT showed an anatomical articular reduction in all patients. Tibial shaft fracture was treated with intramedullary nailing in 15 patients of the WPM group and seven patients in the PM group. Percutaneous medial plating was used in the rest of the cases. At final follow-up, LEFS score in the PM group was 73.6 vs. 70.6 in the WPM group, with no significant difference (p:0.23). There were also no significant differences in VAS scale, time of return to work and sports in both groups. The PM group scored better in physical (p:0,02) and mental (p:0,01) SF-12. Conclusion: In this series of closed tibial shaft fractures, the presence of a posterior malleolus fracture did not affect functional results, time to return to work, or return to sports. Moreover, the SF-12 was superior in the PM group. All patients in the PM group had a timely diagnosis and anatomical reduction, which probably influenced the good clinical results. There were no additional procedures or degenerative complications in the PM group.

Rates of Return to Sports and Recurrence in Pediatric Athletes after Conservative Treatment for Lumbar Spondylolysis.

Lumbar spondylolysis is common in pediatric athletes, and many athletes can return to sports with conservative treatment. There are two initial treatment strategies: bony union or pain management, but the outcomes of these strategies have not been clarified. The purpose of this study is to investigate the rates of return to sports (RTS) and recurrence in pediatric athletes after conservative treatment for lumbar spondylolysis and to compare both treatment strategies. A total of 180 patients with lumbar spondylolysis were managed with a trunk brace and cessation of sports activity (bone union [BU] group, n=95) or treated for pain only (pain management [PM] group, n=85). RTS and recurrence rates according to type of conservative treatment were compared. The RTS rate was 98.9% in the BU group and 97.6% in the PM group at 4.7±1.9 and 1.8±1.7 months, respectively. Recurrence occurred in 7.4% of patients in the BU group at 19.0±16.0 months and in 4.8% of the PM group at 17.8±5.2 months. The RTS rate in pediatric athletes with lumbar spondylolysis was high at more than 95%, regardless of type of conservative treatment. The mean time to RTS was longer in the BU group than in the PM group (4.7 vs. 1.8 months) because of the time required for bone healing. There were several cases of recurrence after RTS. Strategies to prevent recurrence of lumbar spondylolysis in pediatric athletes are discussed.

475. IMPACT OF SURGERY START TIME ON SHORT TERM OUTCOMES OF ELECTIVE ESOPHAGECTOMY FOR CANCER

Abstract As the number of patients with esophageal cancer is increasing, it is expected to lead to an increased work for surgeons. However, surgeons would work less effectively with fatigue accumulation during the course of a normal workday. We examined the impact of surgery start time and work load on short-term outcomes of patients undergoing elective esophagectomy for caner. This was a retrospective analysis of a single medical center dataset that included all patients (n = 614) who had undergone elective esophagectomy for cancer between 2010 and 2022. Patients were categorized according to the start times of surgery (AM group: 8am-1pm, n = 491; PM group: 1pm-5pm, n = 123). Post-operative outcomes and short-term survival were taken as primary end point. The baseline characteristics of the AM and PM group were similar. The AM group had longer operation time (443.29±89.31 vs. 410±81.55, p &amp;lt; 0.001). The rate of unplanned conversion to laparotomy from laparoscopy was higher in the PM group with borderline significance (0.2% vs. 0.7%, p= 0.08). Both of the oncological outcomes and the incidence of the postoperative complications were similar between two groups (all p &amp;gt; 0.05). In short term survival, patients in the PM group had higher 180-day mortality (9.3% vs. 16.3%, p= 0.045). Surgery start times might contribute to higher conversion rate in abdominal part of surgery. Otherwise, surgery start times and workload of surgeons during working time did not affect short-term outcomes of elective esophagectomy for cancer.

Longitudinal Changes in Lens Thickness and Lens Power Among Persistent Non-Myopic and Myopic Children.

PurposeTo assess the longitudinal changes in crystalline lens in persistent non-myopic and myopic children.MethodsFour cohorts of children were recruited from Guangzhou, China, from first year of kindergarten (G0, n = 1129), first year of primary school (G1, n = 1324), fourth year of primary school (G4, n = 1854), and first year of junior high school (G7, n = 867) in 2018 and followed up annually for 2 years. All children received cycloplegic autorefraction and ocular biometry measurement. Children were classified into categories of persistent non-myopia (PNM; spherical equivalent refraction [SER] ≥−0.5 diopter [D] at baseline and during follow-up), persistent myopia (PM; SER <−0.5 D at baseline and during follow-up), or newly developed myopia (NDM: SER ≥−0.5 D at baseline and <−0.5 D during follow-up).ResultsThe mean (SD) age was 3.69 (0.34) years for children in G0, 6.79 (0.35) years in G1, 9.52 (0.42) years in G4, and 12.56 (0.38) years in G7. A LOWESS plot showed a three-stage pattern of change in lens thickness (LT) in PNM children including a rapid decrease from 3 to 7 years of age and a slower decrease from 7 to 11 years, followed by an increase thereafter. Similar trends were observed in the PM and NDM groups, although there was less change in LT. In contrast, lens power (LP) decreased consistently in all cohorts during the follow-up. No significant changes in LT or LP were observed around myopia onset.ConclusionsThe lens showed a three-stage pattern of change in LT, whereas there was continuous loss of LP in children ages 3 to 15 years.

Structural and Impedance Analysis of 0.7Pb(Mg1/3Nb2/3)O3-0.3PbTiO3 Ceramic

Background: Since (1-x)[Pb(Mg1/3Nb2/3)O3]-(x)PbTiO3 (PMN-PT) ceramic has a high dielectric constant and piezoelectric coefficient, it has been widely investigated for profound applications in electro-optical devices, sensors, multilayer capacitors and actuators. Objectives: The objective of this paper is to study the structural and electrical properties of 0.7Pb(Mg1/3Nb2/3)O3-0.3PbTiO3 (0.7PMN-0.3PT) ceramic to understand the biphasic structural nature using Rietveld Refinement. Also, it characterises the type of conduction process as well as the role of grain and grain boundary resistance in the material on the basis of electrical properties such as impedance and modulus to understand the relaxation process. Methods: 0.7PMN-0.3PT is synthesised by mixed oxide method using PbO, MgO, Nb2O5 and TiO2 as precursor materials. Results: The XRD data reveals the biphasic structure of the tetragonal phase with the space group of P4mm and the monoclinic phase with the space group of Pm. The complex impedance analysis clearly represents the effect of grain on the overall resistance and departs from normal Debye-type behaviour. Also, the resistance is found to decrease with temperature, thereby confirming the semiconducting nature of the sample. The presence of long as well as short-range mobility of charge carriers is confirmed from the modulus and impedance analysis. The influence of long-range motion is observed at high temperatures and of short-range motion at low temperatures. Conclusion: XRD analysis confirmed the biphasic structure of the M+T phase. The frequencydependent modulus and impedance spectroscopy show the presence of a relaxation effect in the ceramic which is found to increase with temperature. The Nyquist plot shows that the resistance is decreased with temperature, thereby confirming the NTCR behaviour in the studied sample.