Recurrence Period Research Articles

Clinical and radiological outcome following arthroscopic Latarjet with cerclage FiberTape fixation with a minimum 1-year follow-up

The rates of implant-related complications are significant following the Latarjet procedure using metal screws in patients with recurrent shoulder dislocation and bone loss. The purpose of this study is to evaluate the short-term outcome following the arthroscopic Latarjet procedure using cerclage FiberTape (Arthrex, Naples, FL, USA) combined with remplissage and capsulolabral repair. It was hypothesized that performing the procedure with cerclage FiberTape would provide sturdy fixation, comparable to the conventional method of using metal screws, while averting hardware-related complications attributed to the latter in published literature. A prospective study was performed in a single institution between 2020 and 2022, with all surgeries performed by a single fellowship-trained shoulder surgeon who has ample experience in performing arthroscopic screw Latarjet procedures. Patient demographics, number of dislocations before surgery, arm dominance, ligamentous laxity, type of sporting activity, Instability Severity Index Score, and percentage of bone loss on the glenoid and humeral sides were recorded. The patients were followed up with visual analog scale, American Shoulder and Elbow Surgeons score, Rowe score, and Walch-Duplay score preoperatively and postoperatively. The coracoid graft position, healing, and remodeling were assessed with computed tomography scans at 3 months postoperatively. Minimum clinical follow-up was for a period of one year. Overall, 10 patients (all males, average age 28±8.8 years) were operated on with an arthroscopic Latarjet procedure using cerclage FiberTape. The minimum follow-up period was 12 months, and the mean follow-up was 13.2 months. The median and individual visual analog scores during arm motion, American Shoulder and Elbow Surgeons scores, Rowe scores, and Walch-Duplay scores improved in the follow-up period. Computed tomography scans at 3 months showed flushed graft position in 5 patients, medial graft position in two patients, and three patients showed graft nonunion with migration. Out of 10 patients, seven had good graft union in follow-up scans. None of the patients required revision surgery. All three patients with graft nonunion were kept under follow-up beyond the study period for recurrence of instability. Our study demonstrated that arthroscopic Latarjet using cerclage FiberTape fixation combined with remplissage and capsulolabral repair resulted in high rate of graft loosening and migration (30%). Nonetheless, patients in whom the coracoid graft had united, as well as those in whom it had not, all had good to excellent functional and clinical outcomes, no complications, and did not require any revision surgery.

Urban Flood Mitigation Strategies with Coupled Gray–Green Measures: A Case Study in Guangzhou City, China

The integration of gray and green infrastructure has proven to be a feasible approach for managing stormwater in established urban areas. However, evaluating the specific contributions of such coupled strategies is challenging. This study introduced a novel integrated hydrological-hydrodynamic model that takes into account the layout of low-impact development (LID) facilities along with pipeline alignment and rehabilitation. Reliable results from modeling were used to assess the individual contribution of LID and improved drainage facilities to urban flooding mitigation. We selected a natural island in Guangzhou City, China, as the study site. The results indicate that combining three LID measures, namely green roofs, sunken green spaces, and permeable pavements, can reduce total runoff by 41.7% to 25.89% for rainfall recurrence periods ranging from 1 year to 100 years, and decrease the volume of nodal overflow by nearly half during rainfall events of less than 10-year return period. By integrating LID measures with the upgraded gray infrastructure, the regional pipeline overloading condition is substantially alleviated, resulting in a significant improvement in pipeline system resilience. For urban flooding control, it is recommended to integrate sufficient green space and avoid pipe-laying structural issues during urban planning and construction. The findings may assist stakeholders in developing strategies to best utilize gray and green infrastructure in mitigating the negative effects of urban flooding.

Single landslide risk assessment considering rainfall‐induced landslide hazard and the vulnerability of disaster‐bearing body

Quantitative calculation of single landslide risk has great significance for the prevention and treatment of landslides, through analysing the slope stability under different rainfall recurrence periods. In this study, the rainfall of the past 40 years in Xun'wu County of China is counted and the rainfall during the return periods of 10, 20 and 50 years are calculated to form three different rainfall conditions. Then, the stability of Cheng'nan landslide in Xun'wu County is calculated by the Geo‐Studio 2007 software, and the probability of landslide occurrence is obtained by Monte Carlo theory under these three conditions. Next, the field investigation is employed to obtain the statistical results of the buildings and personnel in the affected area of Cheng'nan landslide. Finally, the risk of economic loss and casualty under the three conditions are calculated. It was demonstrated that: (1) Under the three conditions, the safety factor decreased gradually, the rate of decrease was slower in the first 3 days and faster in the middle period and there was still a downward trend after the end of the rain. (2) The probability of landslide occurrence during the rainfall return periods of 10, 20 and 50 years were 1.77%, 2.97% and 1.61%, respectively. Besides, the risk index of landslide was the highest under the condition of 20‐years rainfall return period. (3) The economic loss risk and casualty risk in the rainfall return periods of 10, 20 and 50 years were 122,700‐yuan and 4.11 people, 205,900‐yuan and 6.89 people, as well as 11,600‐yuan and 3.74 people, respectively.

VR Sickness Evaluation Method Using Recurrence Period Density Entropy

The methods for measuring virtual reality (VR) sickness can be divided into objective indicators and subjective surveys. The method using objective indicators measures VR sickness by monitoring changes in the users’ physiological signals. Various physiological indicators have been used with this method, each with a different processing technique and outcome. This diversity complicates the establishment of standardized metrics (such as biodata-based scores and quantification) for VR sickness. Therefore, this study proposes a method for evaluating VR sickness using the recurrence period density entropy (RPDE) and conducts experiments to validate the feasibility of this approach utilizing prominent physiological data, such as electrocardiography data. The experimental results confirm that although RPDE values vary as individual metrics, the changes in these values may be correlated with VR sickness.

Evaluation of the Knowledge and behavior of Indonesian Mothers About Infantile Colic

Introduction: Infantile colic is a functional gastrointestinal disorder (GSCF) found in 20-30% of infants aged 5 months which is characterized by recurrent prolonged periods of infant irritability, fussing, or crying without obvious cause and cannot be prevented or resolved by parents. Infantile colic is often associated with higher mothers depression and lower quality of life. Mothers' knowledge and behavior of infantile colic varies greatly. This research to investigate the knowledge and behavior of Indonesian mothers regarding infantile colic and related factorMethods: A cross-sectional analytic observational study with the target of 100 mothers with babies aged 0-12 months was performed using an electronic questionnaire in Google forms. The questionnaire consists of multiple-choice questions regarding the mothers' knowledge and behavioral to infantile colic.Results: As many as 82% of mothers understand that infantile colic as recurrent prolonged periods of crying that occur without obvious cause and cannot be prevented or resolved by parents, however only 12% of mothers know that most infantile colic will disappear by the age of 5 months. Forty percent mothers had babies with infantile colic; 97.5% of them were worried about their baby's condition and 7.5% of the mothers gave them medication. There was no significant difference between mothers' age and number of children with inadequate mother-infant interaction (P = 0.770 and P = 0.647)Conclusion: The knowledge and behavior of mothers in Indonesia regarding infantile colic is quite good, however parental reassurance still needs to be improved, especially to reduce maternal anxiety.

Hazard Assessment of Debris Flow: A Case Study of the Huiyazi Debris Flow

The Bailong River Basin is situated at the northeastern edge of the Qinghai–Tibet Plateau and the western transition zone of the Loess Plateau, characterized by steep terrain and heavy rainfall. This area experiences frequent occurrences of debris flows, posing serious threats to towns and construction projects. Focusing on the Huaiyazigou debris flow in the Bailong River Basin, numerical simulations of debris flow processes were conducted using Digital Surface Model (DSM) data with a resolution of 5 m × 5 m for various recurrence periods. The simulation results indicate that the debris flow develops rapidly along the gully after formation, decelerating and beginning to deposit upon reaching the cement plant area near the mouth of the gully, eventually merging into the Bailong River. The primary destructive modes of debris flow disasters encompass impact and burial. When encountering buildings, their flow characteristics manifest as deposition and diversion. A debris flow hazard classification model, based on intensity and recurrence periods, was established according to Swiss and Austrian standards, dividing the hazard into low, medium, and high levels. This method generated a debris flow hazard zone map, offering guidance for risk prevention and monitoring. This research demonstrates that using high-precision Digital Surface Models (DSM) can accurately represent the digital information of debris flow gully terrains and buildings. During the simulation process, it realistically reflects the characteristics of the debris flow movement, allowing for the more precise delineation of hazard zones.

Precondition Study of a Sponge City: Comprehensive Assessment of the Vulnerability of an Urban Rainwater System

This study introduces the concept of urban rainwater system vulnerability and identifies the indicator factors that affect the vulnerability of rainwater systems. Using the analytic hierarchy process (AHP), an index system for the vulnerability assessment of the rainwater system was established, and a vulnerability assessment model for the rainwater system was constructed. By integrating vulnerability degree, recurrence period, and water depth of ponding, a vulnerability assessment framework for urban rainwater systems was developed. Taking a newly developed urban area in the Suzhou High-Tech Zone as an example, we calculated the vulnerability degree of the urban rainwater system in this area to be 0.6497, indicating a high level of vulnerability and poor system safety. When encountering rainfall with a recurrence period p > 5 years, the city is likely to experience severe waterlogging. Through the analysis and evaluation of the rainwater system’s vulnerability, while clarifying the current state of the rainwater system, it can provide a scientific reference basis for the system’s upgrade, transformation, and optimized operation and management. Although the selection of factors may not be entirely comprehensive, this method allows for adjustments based on the composition and operation of different rainwater systems.

Juvenile nasopharyngeal angiofibroma: a case report

Introduction: Juvenile nasopharyngeal angiofibroma (JNA) is a rare and locally invasive benign hypervascular neoplasm, representing 0.05 to 0.5% of all neoplasms in the head and neck. Though it is benign, it has an aggressive nature. The clinical presentation of this tumor is a triad of epistaxis, unilateral nasal obstruction, and a mass in the nasopharynx. It could cause massive epistaxis or intracranial involvement, which both lead to fatal consequences. It is most commonly seen in adolescent males because it is considered an androgen-dependent tumor. Case Presentation: This report introduced a case of a 13-year-old Saudi male patient who presented two months after surgical removal of JNA with a complaint of progressively left-sided nasal blockage, snoring, rhinorrhea, hyposmia, and oral fullness with no epistaxis. Computed tomography (CT) with contrast of the sinuses was done and confirmed the recurrence of angiofibroma. Conclusion: This report revealed a recurrent period of two months after the surgical removal of a primary tumor, which is shorter than the typical period of recurrence.

Analysis of the Low-Frequency Debris Flow Disaster Induced by a Local Rainstorm on 12 July 2022, in Pingwu County, China

Low-frequency debris flows often lead to severe disasters due to large energy releases and strong concealment. However, the understanding of formation conditions, movement processes, and disaster-causing mechanisms of low-frequency debris flow is still limited, especially regarding occurrences within the large catchment (>50 km2). This study presents a typical case of large-scale, low-frequency debris flow occurring in the Heishui catchment (102.65 km2), Pingwu County, China. The movement process, disaster characteristics, and causes of the Heishui debris flow were analyzed in detail through field investigations and remote sensing interpretation. The results indicated that the Heishui debris flow is a large-scale, low-frequency, dilute debris flow with a recurrence period of over 100 years. The debris flow was primarily initiated from the right branch gully, Longchi gully, triggered by a local rainstorm with a maximum hourly rainfall return period of over 20 years. The main cause of casualties and building damage is attributed to large energy releases from boulder blockages and outbursts that occurred in the middle part of the main channel. This led to a sudden increase in peak discharge to 1287 m3/s, with a volume of 3.5 × 105 m3 of solid materials being transported to the outlet of the gully. It is essential to enhance the identification of debris flows by comprehensively considering tributary gullies’ susceptibility and strengthening joint meteorological and hydrological monitoring networks in the middle and upper reaches within large catchments. This preliminary work contributes towards improving prevention and mitigation strategies for low-frequency debris flows occurring within large catchments.

Multiwavelength Observations of Multiple Eruptions of the Recurrent Nova M31N 2008-12a

We report the optical, UV, and soft X-ray observations of the 2017–2022 eruptions of the recurrent nova M31N 2008-12a. We find a cusp feature in the r′ - and i′ -band light curves close to the peak, which could be related to jets. The geometry of the nova ejecta based on morpho-kinematic modeling of the Hα emission line indicates an extended jet-like bipolar structure. Spectral modeling indicates an ejecta mass of 10−7–10−8 M ⊙ during each eruption and an enhanced helium abundance. The supersoft source phase shows significant variability, which is anticorrelated to the UV emission, indicating a common origin. The variability could be due to the reformation of the accretion disk. We infer a steady decrease in the accretion rate over the years based on the intereruption recurrence period. A comparison of the accretion rate with different models on the MWD–Ṁ plane yields the mass of a CO white dwarf, powering the H-shell flashes every ∼1 yr, to be >1.36 M ⊙ and growing with time, making M31N 2008-12a a strong candidate for the single degenerate scenario of the Type Ia supernovae progenitor.

Enhanced Typhoon-Induced Design Wave Height Estimation for Ocean Engineering Applications Using High Performance Computing

Coastal construction heavily depends on accurately estimating design wave parameters. This paper presents a technique for calculating ocean engineering design wave heights that addresses the challenges of inadequate wind speed and measured wave data in the field using High Performance Computing (HPC). The proposed method combines the Simulating WAves Nearshore (SWAN) wave model driven by wind with two different wind field models: the NCEP/NCAR reanalysis wind field and the Jelesnianski typhoon model wind field. By combining these models, the study reduces the underestimation of wind speed and inaccurate depiction of typhoon-related details. The method's effectiveness is demonstrated by applying it to calculate the design wave elements of the deep-sea breeding platform in Dongluo Island, Fujian. The study results show that the platform can experience a maximum wave height of 9.42 m during a 50-year recurrence period. The research shows that the platform's southwest corner is the most vulnerable location. This new calculation method is a significant improvement in ocean engineering design since it overcomes the limitations that come with the lack of wind speed and measured waves. By utilizing multiple wind field models, the calculated wave heights' accuracy and reliability is considerably enhanced. The application of this method to the breeding platform in Dongluo Island has yielded valuable insights for designing resilient structures in similar oceanic environments. This study demonstrates the important application of computational numerical simulations in the field of ocean engineering, providing high-precision predictive capabilities for structural design and risk assessment.

Environmental Regulation and Stormwater Management Strategies for an Urban River in Northwest China: A Sustainable Approach

Low-impact developments (LIDs) have emerged as effective strategies for mitigating the adverse impacts of urbanization on river environments. This study aims to enhance river environment quality by examining the effects of LIDs and land use/cover change (LUCC) in the context of river environment and hydrological conditions. Using the Stormwater Management Model (SWMM) in an urban river setting, the study investigates the impact of LIDs on urban river water volume. An analysis of river runoff quality and quantity is conducted, followed by the development of an optimal river water regulation scheme through a multi-objective ecological scheduling model. The results reveal that the incorporation of LIDs can substantially decrease river runoff yield for varying recurrence periods of design rainstorms. Consequently, the flood peak reduction rate ranged from 10% to 18%, and the flood volume experienced a reduction of 10–29% in the study area. The combination of river water regulation, LIDs and LUCC leads to a decrease in river water volume within the lower river channel by up to 47% especially in a typical dry year and dry season, accompanied by a decline in river flow velocity and water self-purification capacity. A risk-based multi-objective stochastic optimization model is employed to ensure sustainable management of urban river runoff in terms of both quantity and quality. This research contributes to the advancement of knowledge in sustainable basin management practices and offers practical insights for policymakers involved in the management of water resources and environmental conservation in semi-arid basins.

Construction of hydrological and hydrodynamic models based on ARM architecture processor – A case study of inner Harbor area of Macao Peninsula

ABSTRACT Green computing is the current research hotspot; adapting the professional computing model to the low-power ARM architecture processor is a research trend. This article constructs a hydrological–hydrodynamic model by choosing SWMM and TELEMAC-2D as submodules, taking stormwater grates and inspection wells as water flow exchange nodes. The container technology was selected to couple the model on the ARM architecture processor, and the adapted coupling model is named the ARM hydrological–hydrodynamic model (AHM). To verify the reasonableness and accuracy of the model, taking the inner harbor of Macao Peninsula as the study area, a numerical simulation study on the evolution of waterlogging was carried out in various scenarios. The analysis showed that the maximum flow velocity was concentrated in the streets with low topography in the city center, and the areas of standing water were distributed in a point-like manner. Risk distribution maps during different storm recurrence periods were also constructed. Finally, the direct economic losses caused by Typhoon Mangkhut were calculated based on the model results and compared with the statistical values, with an error of only 2.3%, and the direct flooding losses in the inner harbor area under different rainfall scenarios were derived accordingly.

Application of iron-manganese oxide fillers in bioretention facility: Enhanced removal of antibiotics and conventional contaminants

Bioretention facilities are common source reduction facilities, but traditional fillers are not effective in reducing emerging contaminants such as antibiotics. Although Fe-Mn oxides have been extensively explored, their removal of emerging contaminants and application in the sponge city have not yet been addressed. Therefore, this study aims to address this limitation by developing Fe-Mn oxide fillers. In this research, the optimal preparation conditions (Fe/Mn mole ratio, polyvinyl alcohol (PVA) concentration, and filler particle size) and influencing factors (filler dosage, initial pollutant concentration, pH, temperature, and co-existing ions) were investigated using a typical antibiotic, norfloxacin (NOR), as the target contaminant. The removal mechanism of NOR was investigated by SEM, FTIR, and XPS characterizations. Subsequently, the fillers were applied to bioretention facilities with different filling modes (layered and mixed) to evaluate their effectiveness in removing NOR and conventional pollutants at different recurrence periods, drought periods, and pollutant influent concentrations. The study indicated that Fe-Mn oxide filler (Fe/Mn mole ratio of 4:1, PVA concentration of 7 %, particle size of 4 mm) could remove more than 70 % of NOR (1–20 mg/L). The NOR removal by Fe-Mn oxide filler involved adsorption and redox reactions. Notably, bioretention facilities using Fe-Mn oxide fillers have shown varying degrees of improvement in the removal of NOR and conventional pollutants compared to conventional ones. This study contributes to the application of Fe-Mn oxide filler in bioretention facilities, thus playing a crucial role in mitigating antibiotic pollution in stormwater runoff.

Effects of resource availability and interspecific interactions on Arctic and red foxes' winter use of ungulate carrion in the Fennoscandian low-Arctic tundra.

In the Arctic tundra, predators face recurrent periods of food scarcity and often turn to ungulate carcasses as an alternative food source. As important and localized resource patches, carrion promotes co-occurrence of different individuals, and its use by predators is likely to be affected by interspecific competition. We studied how interspecific competition and resource availability impact winter use of carrion by Arctic and red foxes in low Arctic Fennoscandia. We predicted that the presence of red foxes limits Arctic foxes' use of carrion, and that competition depends on the availability of other resources. We monitored Arctic and red fox presence at supp lied carrion using camera traps. From 2006 to 2021, between 16 and 20 cameras were active for 2 months in late winter (288 camera-winters). Using a multi-species dynamic occupancy model at a week-to-week scale, we evaluated the use of carrion by foxes while accounting for the presence of competitors, rodent availability, and supplemental feeding provided to Arctic foxes. Competition affected carrion use by increasing both species' probability to leave occupied carcasses between consecutive weeks. This increase was similar for the two species, suggesting symmetrical avoidance. Increased rodent abundance was associated with a higher probability of colonizing carrion sites for both species. For Arctic foxes, however, this increase was only observed at carcasses unoccupied by red foxes, showing greater avoidance when alternative preys are available. Supplementary feeding increased Arctic foxes' carrion use, regardless of red fox presence. Contrary to expectations, we did not find strong signs of asymmetric competition for carrion in winter, which suggests that interactions for resources at a short time scale are not necessarily aligned with interactions at the scale of the population. In addition, we found that competition for carcasses depends on the availability of other resources, suggesting that interactions between predators depend on the ecological context.

A fractional mathematical model approach on glioblastoma growth: tumor visibility timing and patient survival

In this paper, we introduce a mathematical model given by
 \begin{equation}
 { }^c \mathfrak{D}_t^\alpha u = \nabla \cdot \mathrm{D} \nabla u + \rho f(u) \quad \text{in } \Omega,
 \end{equation}
 where $f(u)=\frac{1}{1-u/\mathrm{K}}, \, u/\mathrm{K} \neq 1, \, \mathrm{K} > 0$, to enhance established mathematical methodologies for better understanding glioblastoma dynamics at the macroscopic scale. The tumor growth model exhibits an innovative structure even within the conventional framework, including a proliferation term, $f(u)$, presented in a different form compared to existing macroscopic glioblastoma models. Moreover, it represents a further refined model by incorporating a calibration criterion based on the integration of a fractional derivative, $\alpha$, which differs from the existing models for glioblastoma. Throughout this study, we initially discuss the modeling dynamics of the tumor growth model. Given the frequent recurrence observed in glioblastoma cases, we then track tumor mass formation and provide predictions for tumor visibility timing on medical imaging to elucidate the recurrence periods. Furthermore, we investigate the correlation between tumor growth speed and survival duration to uncover the relationship between these two variables through an experimental approach. To conduct these patient-specific analyses, we employ glioblastoma patient data and present the results via numerical simulations. In conclusion, the findings on tumor visibility timing align with empirical observations, and the investigations into patient survival further corroborate the well-established inter-patient variability for glioblastoma cases.

Clinical features of patients with hepatocellular carcinoma treated with radiofrequency ablation therapy: developing a simple score to determine the need for immune-adjuvant therapy.

Unresectable recurrence after curative treatments for hepatocellular carcinoma (HCC) is a life-limited event. Although the IMbrave050 trial (IM050) showed a favorable reduction in recurrence with adjuvant immune-combination chemotherapy, inclusion criteria of the radiofrequency ablation (RFA) group were lower risk than that of the resection group. This study aimed to elucidate the clinical features of patients treated with RFA, which really need adjuvant-chemotherapy. From 2000 to 2022, 528 patients with Child-Pugh A and HCC within the Milan criteria (MC), who met the IM050 criteria for RFA and undergone resection or RFA, were enrolled (71years, HCV:HBV:HBV/HCV:alcohol:others = 337:44:5:53:89, multi-tumor = 138, RFA:resection = 309:219). Unresectable recurrence was defined as beyond the MC. Risk factors for recurrence beyond the MC were retrospectively evaluated. Multivariate Cox-hazard analysis showed HCV-positive (HR 1.49), AFP-L3 > 10% (HR 1.75), and DCP > 100mAU/mL (HR1.80) as significant prognostic factors for recurrence beyond the MC (each P < 0.05). Summing of positive factors (1 point for each) was used for scoring (AD-ON score), which showed increased positive rates for micro-hepatic vein invasion (score 0:1:2:3 = 0%:1.1%:6.6%:15.8%), micro-portal vein invasion (0:1:2:3 = 2.0%:12.1%:14.1%:31.6%), and poor differentiation (0:1:2:3 = 6.0%:6.7%:15.3%:15.8%) in the resection group associated with a greater score (each P < 0.01). In patients treated with RFA, those with greater AD-ON scores showed shorter time to recurrence beyond the MC, recurrence-free time, and overall survival (score 0:1:2:3 = no-estimation:97:66:23months, 35:27:20:12months, and 91:82:67:52months, respectively, each P < 0.05). HCC patients treated by RFA and with a high AD-ON score (≧2) should be considered for aggressive adjuvant-chemotherapy to prolong the period of recurrence beyond the MC.

Abstract 1598: Individualized longitudinal assessment reveals therapy-induced tumor and microenvironment dynamics in preclinical pancreatic cancer models

Abstract Background &amp; Aim: Progression and therapeutic resistance in pancreatic cancer depends on the ability of cancer cells to adopt specific cell states. These phenotypes largely depend on environmental tissue niches. Here, we investigated therapy-induced tumor dynamics in vivo at single-cell spatial and temporal resolution in different subtypes of PDAC using several genetically engineered mouse models, which reflect distinct human PDAC ecosystems. Methods &amp; Results: We established orthotopic tumor models of pancreatic cancer with distinct tumor microenvironment (TME) formation (reactive vs deserted stroma), which were monitored for tumor growth to define tumor response patterns under MAPK inhibition. Serial ultrasound-guided biopsy sampling was performed to collect tissues from the same tumors at pre-treatment, responsive and recurrence periods.Transcriptomic analysis of biopsies using the Mfuzz algorithm delineated highly dynamic gene and pathway activities during treatment. Reactive, but not deserted, TME showed an upregulation of immune-related pathways (antigen presentation, T cell receptor, NK cytotoxicity) immediately after MAPK inhibition in regressed tumors that dropped dramatically during recurrence of tumors, in which upregulation of TGF-b signaling was observed. In the deserted stroma model, on the other hand, an enrichment in drug metabolic pathways during recurrence was observed.CAF cluster deconvolution analysis revealed an increase in a LRRC15+ CAF cluster, which was TGF-b-driven and immunosuppressive, during recurrence period only in the reactive model. The dynamic changes of immune cells and CAFs were validated at protein level by multiplex immunofluorescent imaging. Cmputational spatial analysis revealed a tumor-encapsulating and CD8+ cytotoxic T cell-repelling pattern exhibited by LRRC15+FAP+ CAFs, implying a potential role of this CAF subset in T cell suppression during recurrence in reactive subtype. Using spectral cell sorting with CellView image technology, specific CAF subsets, tumor cells as well as immune cell subsets based on 30+ markers and cell morphology were isolated, characterized and assessed by ex vivo functional assays to confirm the immunosuppressive and tumor protective mechanism mediated by CAFs. Conclusion: Longitudinal in vivo assessment of distinct PDAC subtypes provides deep mechanistic insights to accurately unlock specific response patterns of tumors with heterogeneous TME dynamics upon therapeutic perturbation, leveraging identification of key nodes for intervention. Citation Format: Jens T. Siveke, Rui Fang, Phyllis Fung-Yi Cheung, Jiajin Yang, Juanfei Peng, Kristina Althoff, Konstantinos Savvatakis. Individualized longitudinal assessment reveals therapy-induced tumor and microenvironment dynamics in preclinical pancreatic cancer models [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 1598.

Long-term outcomes of robot-assisted versus minimally invasive esophagectomy in patients with thoracic esophageal cancer: a propensity score-matched study

BackgroundRecently, robot-assisted minimally invasive esophagectomy (RAMIE) has gained popularity worldwide. Some studies have compared the long-term results of RAMIE and minimally invasive esophagectomy (MIE). However, there are no reports on the long-term outcomes of RAMIE in Japan. This study compared the long-term outcomes of RAMIE and MIE.MethodsThis retrospective study included 86 patients with thoracic esophageal cancer who underwent RAMIE or MIE at our hospital from June 2010 to December 2016. Propensity score matching (PSM) was employed, incorporating co-variables such as confounders or risk factors derived from the literature and clinical practice. These variables included age, sex, body mass index, alcohol consumption, smoking history, American Society of Anesthesiologists stage, comorbidities, tumor location, histology, clinical TNM stage, and preoperative therapy. The primary endpoint was 5-year overall survival (OS), and the secondary endpoints were 5-year disease-free survival (DFS) and recurrence rates.ResultsBefore PSM, the RAMIE group had a longer operation time (min) than the MIE group (P = 0.019). RAMIE also exhibited significantly lower blood loss volume (mL) (P < 0.001) and fewer three-field lymph node dissections (P = 0.028). Postoperative complications (Clavien–Dindo: CD ≥ 2) were significantly lower in the RAMIE group (P = 0.04), and postoperative hospital stay was significantly shorter than the MIE group (P < 0.001). After PSM, the RAMIE and MIE groups consisted of 26 patients each. Blood loss volume was significantly smaller (P = 0.012), postoperative complications (Clavien–Dindo ≥ 2) were significantly lower (P = 0.021), and postoperative hospital stay was significantly shorter (P < 0.001) in the RAMIE group than those in the MIE group. The median observation period was 63 months. The 5-year OS rates were 73.1% and 80.8% in the RAMIE and MIE groups, respectively (P = 0.360); the 5-year DFS rates were 76.9% and 76.9% in the RAMIE and MIE groups, respectively (P = 0.749). Six of 26 patients (23.1%) in each group experienced recurrence, with a median recurrence period of 41.5 months in the RAMIE group and 22.5 months in the MIE group.ConclusionsCompared with MIE, RAMIE led to no differences in long-term results, suggesting that RAMIE is a comparable technique.

Exploring influences and risk of bias of studies on return to sport and work after lateral ankle sprain: A systematic review and meta-analysis

BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity, with an incidence rate of 15%-20%. The high incidence and prevalence highlights the economic impact of this injury. Ankle sprains lead to a high socioeconomic burden due to the combination of the high injury incidence and high medical expenses. Up to 40% of patients who suffer from an ankle sprain develop chronic ankle instability. Chronic instability can lead to prolonged periods of pain, immobility and injury recurrence. Identification of factors that influence return to work (RTW) and return to sports (RTS) after a lateral ankle sprain (LAS) may help seriously reduce healthcare costs. AIM To explore which factors may potentially affect RTW and RTS after sustaining an LAS. METHODS EMBASE and PubMed were systematically searched for relevant studies published until June 2023. Inclusion criteria were as follows: (1) Injury including LAS or chronic ankle instability; (2) Described any form of treatment; (3) Assessment of RTW or RTS; (4) Studies published in English; and (5) Study designs including randomized controlled clinical trials, clinical trials or cohort studies. Exclusion criteria were: (1) Studies involving children (age &lt; 16 year); or (2) Patients with concomitant ankle injury besides lateral ankle ligament damage. A quality assessment was performed for each of the included studies using established risk of bias tools. Additionally quality of evidence was assessed using the GRADEpro tool in cases where outcomes were included in the quantitative analysis. A best evidence synthesis was performed in cases of qualitative outcome analysis. For all studied outcomes suitable for quantitative analysis a forest plot was created to calculate the effect on RTW and RTS. RESULTS A total of 8904 patients were included in 21 studies, 10 randomized controlled trials, 7 retrospective cohort studies and 4 prospective cohort studies. Fifteen studies were eligible for meta-analysis. The overall RTS rate ranged were 80% and 83% in the all treatments pool and surgical treatments pool, respectively. The pooled mean days to RTS ranged from 23-93 d. The overall RTW rate was 89%. The pooled mean time to RTW ranged from 5.8-8.1 d. For patients with chronic ankle instability, higher preoperative motivation was the sole factor significantly and independently (P = 0.001) associated with the rate of and time to RTS following ligament repair or reconstruction. Higher body mass index was identified as a significant factor (P = 0.04) linked to not resuming sports or returning at a lower level (median 24, range 20-37), compared to those who resumed at the same or higher level (median 23, range 17-38). Patients with a history of psychological illness or brain injury, experienced a delay in their rehabilitation process for sprains with fractures and unspecified sprains. The extent of the delayed rehabilitation was directly proportional to the increased likelihood of experiencing a recurrence of the ankle sprain and the number of ankle-related medical visits. We also observed that 10% of athletes who did return to sport after lateral ankle sprain without fractures described non-ankle-related reasons for not returning. CONCLUSION All treatments yielded comparable results, with each treatment potentially offering unique advantages or benefits. Preoperative motivation may influence rehabilitation after LAS. Grading which factor had a greater impact was not possible due to the lack of comparability among the included patients.