Stage Migration Research Articles

Migration behaviors leaving metropolitan areas: assessing the impacts of health risks and teleworking in the COVID-19 context

An increase in the number of people leaving metropolitan areas (MAs) was observed in various countries in the early years of the COVID-19 pandemic. While considerable attention has been paid to the impacts of health risks and teleworking, two prominent topics related to health-crisis-led migration, empirical evidence remains inadequate. This study aims to empirically investigate the impacts and temporal changes of these two factors on migration leaving MAs (LMA migration). It utilizes survey data from the Japanese government and employs fixed effects logit models. (1) By using infection rates in a more accurate measurement than previous studies, this study confirms the health-risk-aversion motives in LMA migration. (2) Teleworking’s influence on LMA migration is found to be insignificant over the long term. Nevertheless, it increases the likelihood of formal employees staying in MAs and strengthens the tendency of the self-employed to leave for local areas. (3) Temporally, the significant impact of lower COVID-19 infection rates attracting metropolitan residents persisted beyond the pandemic stringency and continued for several months afterward, though it eventually reversed. Teleworking shows a positive influence on LMA migration only in the later stage of COVID-19. These findings suggest a tendency of ‘deferred decisions’ in LMA migration due to people’s unfamiliarity with an unprecedented health crisis. However, the negative impact of infection risks emerges sooner than the significant effect of teleworking, indicating that safety is a pressing priority for LMA migration in the early stages of a major health crisis. (4) Self-employed individuals, homeworkers, and the unemployed are more likely to engage in LMA migration, while employees (whether formal or informal) are less likely, highlighting the role of opportunity costs. Policy implications suggest that local governments should focus on attracting the self-employed from MAs during health crises and on enhancing the teleworking environment for the long term.

Dynamic characteristics of soil pore structure and water-heat variations during freeze-thaw process

Freeze-thaw processes in cold regions alter soil pore structure and properties, leading to engineering geological issues. Soil pores are crucial, but research on their changes and freeze-thaw impacts is limited. This study used MRI-Cryogenic Soil Moisture Analyzer (MRI-CSMA) to explore pore structure, water, and temperature changes in saturated loess during freeze-thaw, and Scanning Electron Microscopy (SEM) to compare changes before and after. The results indicate that during the freezing process, the temperature in the frozen zone of the soil sample exhibited a staged change characterized by rapid cooling, transitional cooling, and stabilization at low temperatures, while the temperature decrease in the unfrozen zone showed no significant stages. Freeze-thaw action significantly affected the macropores and mesopores in the frozen zone, with an average increase of 15 % in macropores, a decrease of 16 % in mesopores, and minimal change in micropores (about a 1 % increase). In the unfrozen zone, there was a slight increase in micropores and mesopores (2 % and 3 %, respectively), and a 4 % decrease in macropores. Furthermore, during the freezing process, macropores in the unfrozen zone gradually decreased, while mesopores and micropores increased, leading to soil structure densification and promoting water migration towards the freezing front. This resulted in an initial increase followed by a decrease in water content near the freezing front during the early stages of freezing, confirming the view that pore structure compression drives water migration in the early stages of soil freezing. This study provides important insights for addressing engineering geological issues in cold regions under freeze-thaw conditions.

The bone Gla protein osteocalcin is expressed in cranial neural crest cells.

Osteocalcin is a small protein abundant in the bone extracellular-matrix, that serves as a marker for mature osteoblasts. To become activated, osteocalcin undergoes a specific post-translational carboxylation. Osteocalcin is expressed at advanced stages of embryogenesis and after birth, when bone formation takes place. Neural crest cells (NCCs) are a unique cell population that evolves during early stages of development. While initially NCCs populate the dorsal neural-tube, later they undergo epithelial-to-mesenchymal-transition and migrate throughout the embryo in highly-regulated manner. NCCs give rise to multiple cell types including neurons and glia of the peripheral nervous system, chromaffin cells and skin melanocytes. Remarkably, in the head region, NCCs give rise to cartilage and bone. Here we report that osteocalcin is detected in cranial NCCs. Analysis of chick embryos at stages of cranial NCC migration revealed that osteocalcin mRNA and protein is expressed in pre-migratory and migratory NCCs in-vivo and ex-vivo. Addition of warfarin, an inhibitor of osteocalcin carboxylation, onto neural-tube explants, reduced the amount of NCC migration. These results provide the first evidence of osteocalcin presence in cranial NCCs, much before they give rise to craniofacial skeleton, and propose its possible involvement in the regulation of NCC migration.

Tumor regression after neoadjuvant hormonal therapy in high risk prostate cancer: pathological outcomes from a randomized phase II trial.

High-risk localized prostate cancer (HRLPC) commonly progresses to metastatic disease after local treatment. Neoadjuvant androgen deprivation therapy (nADT) before radical prostatectomy (RP) has recently been suggested to improve early oncological outcomes in HRLPC. We aimed to perform an exploratory analysis of the pathological outcomes from a prospective trial testing nADT before RP. Prospective, single-centered, phase II, randomized trial performed between October 2018 and July 2021. Random assignment (1:1) for nADT modalities: goserelin (10.8mg) plus abiraterone acetate (1000mg/d) plus prednisone (5mg/d), with or without apalutamide (240mg/d) for 12 weeks, followed by RP (within 30 days) and extended lymph node dissection. Baseline clinical and pathological variables were assessed in needle biopsies before nADT. Tumor regression was histologically evaluated in surgical specimens using the residual cancer burden index (RCB). Sixty-two patients reached the surgical phase. Good response (RCB ≤ 0.25cm³) was achieved in 14 patients (22.5%). Overall stage migration rate between baseline status (MRI before nADT) and final status (after surgery) was 27.4%. Late stage detection (high tumor burden, perineural invasion) and altered PTEN/ERG immunostatus showed significant association with poor response in univariate analysis. Higher baseline tumor burden was the only independent factor related to poor response in multivariate analysis. There are subgroups of patients, such as those with low baseline cancer burden and PTEN/ERG wild-type status, more likely to achieve good response with nADT. In the case of long term oncological benefit to be proven, nADT might be an additional therapeutic resource for these patients.

Impact of FIGO 2023 staging criteria for endometrial cancer on stage migration and survival outcomes

Impact of FIGO 2023 staging criteria for endometrial cancer on stage migration and survival outcomes

Lithium-ion comb—artificial self-regulating lithium-storage film on aluminum anode enabling long cycles of batteries

Al anode can increase battery energy density, but its non-wettability and high Li nucleation hindrance cause uneven Li nucleation to deteriorate the anode structure. Herein, we present a novel in-situ synthesis method for the deposition of molybdenum oxide nanospheres (NMO) onto the surface of Al foil, that is, molybdenum oxide/aluminum (M-Al), which demonstrates a two-stage propulsion effect on Li-ion migration to address the issue at hand. The high wettability and low Li nucleation hindrance of the NMO layer drive the first stage of Li-ion migration. NMO acted as a comb to deliver Li ions uniformly with minor volume expansion. Subsequently, the formation of Li2O-rich solid electrolyte interphase (SEI) film with exceptional desolvation capability, facilitated by the NMO layer and electrochemically activated M-Al to Li molybdate/aluminum (Li-M-Al), represents the second stage in the advancement of Li−ion migration. The embedding of lithium ions makes molybdenum oxide evolve into lithium molybdate, thereby enabling Mo to regulate the storage of Li ions through the valence state. Hence, the Li nucleation overpotential of M-Al is decreased by 0.32 V, leading to a significant enhancement in the cycling performance of the Li-M-Al||LiFePO4 (LFP) battery, with a capacity retention rate of 78.5 % after 400 cycles at 1C.

Roles of Chemokine Axes in Breast Cancer.

Chemokines bind to specific chemokine receptors, known as cell surface G protein-coupled receptors, constructing chemokine axes which lead to cell migration and invasion in developmental stage, pathophysiological process, and immune reactions. The chemokine axes in the tumor microenvironment are involved in tumor growth, angiogenesis, cancer stem-like cell properties, metastasis, and chemoresistance, modifying tumor immune contexture and cancer progression. Clinical features, including tumor state, grade, lymph node metastasis, and cancer subtypes, are related to the specific chemokine axes, which play a significant role in immune contexture and cell to cell interaction in the tumor microenvironment, followed by altered cancer prognosis and overall survival. The present review summarizes the role of chemokine axes in breast cancer, based on data obtained from cell line and animal models and human tumor samples. This review provides information that understand the important roles of each chemokine axis in breast cancer, probably offering a clue of adjuvant therapeutic options to improve the quality of life and survival for patients with breast cancer.

Exploring financial reverse remittances. A quantitative study in the Italian context

ABSTRACT While many studies examine the remittances sent by migrants to their home countries, little is known about the financial resources that flow from home countries to migrants abroad, also known as reverse remittances. Following an in-depth analysis of the limited existing literature, our study focuses on the practice of financial reverse remittances among migrants living in the Italian region of Lombardy to assess their incidence, their relationship with the migrants’ migration stage, and the occurrence of economic hardship. We build on a quantitative survey of 4,000 migrants carried out in 2014. Our research shows that overseas students, long-term migrants living with a partner, and, in general, migrants facing economic hardship and job insecurity are more likely to receive financial reverse remittances. The implications of our findings in light of the 2007–2008 global financial crisis in Italy are also discussed.

Stage migration and survival outcomes in patients with cervical cancer at Stage IIIC according to the 2018 FIGO staging system: a systematic review and meta-analysis.

To summarize stage migration and survival outcomes in patients with cervical cancer at Stage IIIC according to the 2018 FIGO staging system, and to investigate prognostic factors influencing Stage IIIC1. PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), International Clinical Trials Registry Platform (ICTRP), and Clinical Trials.gov were searched from inception to February 6, 2024. The analysis was conducted using STATA 16.0. A total of 25 studies with 82954 cervical cancer patients were included in the analysis. The migration rates to FIGO 2018 Stage IIIC ranged from 18% to 37% for early-stage tumors (Stage IB to IIA) in FIGO 2009, and from 32% to 52% for advanced stage tumors (Stage IIB to IIIB). The overall survival (OS) for Stage IIIC1 is poorer compared to Stage IB1 (HR 0.53, 95% CI 0.35-0.80, p=0.003) and Stage IB2 (HR 0.61, 95% CI 0.43-0.85, p=0.004). It is comparable to Stage IB3, yet it shows better survival outcomes than Stages IIB (HR 2.91, 95% CI 1.01-8.39, p=0.047), IIIA (HR 1.96, 95% CI 1.78-2.17, p=0.000), and IIIB (HR 1.56, 95% CI 1.04-2.35, p=0.031). Tumors size ≥4cm (HR 1.45, 95% CI 1.10-1.92, p=0.00), metastatic lymph node ≥ 3 (HR 2.21, 95% CI 1.56-3.15, p=0.000) and T stage are prognostic factors for OS of Stage IIIC1. The migration rates to FIGO 2018 Stage IIIC varied between 18% and 52% for patients initially classified under FIGO 2009 Stages IB1 to IIIB. The FIGO 2018 staging system underscores the pivotal role of lymph node metastasis in predicting prognosis and provides valuable insights into the distinct prognostic implications associated with different stages, particularly for early stages. For advanced stages, incorporation of tumor-related factors such as T stage might better elucidate survival differences and guide clinical treatment decisions. CRD 42023451793.

The K2-24 planetary system revisited by CHEOPS

The planetary system K2-24 is composed of two transiting low-density Neptunians locked in an almost perfect 2:1 resonance and showing large transit time variations (TTVs), and it is an excellent laboratory to search for signatures of planetary migration. Previous studies performed with K2, Spitzer, and RV data tentatively claimed a significant non-zero eccentricity for one or both planets, possibly high enough to challenge the scenario of pure disk migration through resonant capture. With 13 new CHEOPS light curves (seven of planet b, six of planet c), we carried out a global photometric and dynamical re-analysis by including all the available literature data as well. We obtained the most accurate set of planetary parameters to date for the K2-24 system, including radii and masses at 1% and 5% precision (now essentially limited by the uncertainty on stellar parameters) and non-zero eccentricities eb = 0.0498−0.0018+0.0011, ec = 0.0282−0.0007+0.0003 detected at very high significance for both planets. Such relatively large values imply the need for an additional physical mechanism of eccentricity excitation during or after the migration stage. Also, while the accuracy of the previous TTV model had drifted by up to 0.5 days at the current time, we constrained the orbital solution firmly enough to predict the forthcoming transits for the next ~15 years, thus enabling efficient follow-up with top-level facilities such as JWST or ESPRESSO.

Controlling Factors of Dissolution Pores in Zeolite Cements of Permian Clastic Rocks in Northwest of Junggar Basin

Abstract Zeolite cement dissolution pores, buried at a depth of over 3600 meters, are found well developed in clastic rocks of Permian in northwest of Junggar basin. Studying the controlling factors of zeolite cement dissolution pores have important meaning to predict the distribution of favorable reservoirs in deep oil and gas exploration of Permian. A comprehensive research method of thin slice analysis of 800 pieces of castings from 60 wells, core observation, scanning electron microscopy, and clay mineral analysis was adopted. It is believed that the dissolution pores of zeolite cements are mainly controlled by zeolite distribution, the scale and range of inorganic and organic acids. Firstly, different zeolite cement types appear a regular pattern that control dissolution pore types and their distribution scope. The study area are well developed three types zeolite cements: heulandite, analcite and laumontite. The heulandite cements are developed in basin edge, showing a belt-like distribution, and then the analcite distribution area. laumontite cements are distributed in basin central. Horizontally in basin edge, reservoir pore type is primary intergranular pore, and followed by analcite dissolution pore. In central basin, the major pore type is laumonitite dissolution pore, and followed by primary intergranular pore. No heulandite dissolution pores are found in study area. Secondly, analcite dissolution pores, formed by inorganic acid and distributed in basin edge, are controlled by the scale of stratigraphic unconformities and faults. Laumonitite dissolution pores, formed by organic acid and developed in central basin, are controlled by the scope of source rock. Thirdly, it is proposed that the meddle-belt of basin is the favorable zone for Permian reservoirs because it is located fan delta front where the laumontite cement is developed, close to the source rock, and in the updip direction of the three stages of organic acid migration. It is considered that central basin has favorable conditions to form laumontite dissolution pores, and pointed out that this zone is a favorable zone for the development of deep reservoirs in the Permian.

Flourine-18 Prostate-Specific Membrane Antigen-1007 Positron Emission Tomography Imaging in Staging of Primary and Secondary Prostate Cancer—A Retrospective Observational Cohort Study

Background: Detection of metastatic disease is important to inform prostate cancer management. Objectives: Evaluate local and distant staging by initial 18F-PSMA-1007 PET in primary and secondary prostate cancer. Design, Setting, and Participants: We retrospectively identified a consecutive series of 18F-PSMA-1007 PET scans from the date of introduction of 18F-PSMA-1007 PET in September 2019 until April 2022 at a single UK tertiary referral center. Our protocol was registered in advance (OSF registration ID: KTE3R). Results: We identified 1335 PSMA-PET scans, from 1220 men. Across 623 initial scans for primary staging, we observed PSMA-PET avidity in 97.6% cases positive for local disease, 29.5% for nodal disease, and 26.5% for metastatic disease. PSMA-PET identified a 13.2% absolute increase in nodal lesions compared with MRI and a 24.0% absolute increase in metastatic lesions compared with MRI marrow. The sensitivity for detection of local disease among 79 patients who had radical prostatectomy was 96.2% for PSMA-PET vs 89.4% for multiparametric MRI. Across 612 scans for secondary staging, we observed PSMA-PET positive avidity in 51.2% of cases for local recurrence, 46.6% for nodal disease, and 43.0% for metastatic disease. When evaluated by the PSA range for patients receiving secondary staging, using the PSA values of 0.2 to 0.49, 0.5 to 0.99, 1 to 1.99, and ≥ 2 ng/mL, PSMA-PET scans were positive in 57.8%, 75.0%, 83.8%, and 95.5% of cases, respectively. PSMA-PET identified a 26.2% absolute increase in metastatic lesions compared with MRI marrow or other skeletal MRI (n = 61) and a 14.7% absolute increase in metastatic lesions compared with the bone scan (n = 42). Conclusion: 18F-PSMA-1007 PET identifies a higher number of nodal and metastatic lesions compared with conventional cross-sectional imaging. However, the high number of indeterminate lesions and stage migration necessitates discussion of 18F-PSMA-1007 PET imaging within a multidisciplinary team and places a higher burden on these teams.

Neoadjuvant Capecitabine in Operable HPV-Negative Head and Neck Cancer: Fortuitous Findings in a Resource Constrained Setting.

Limited progress has occurred in treating operable human papillomavirus (HPV)-negative head and neck squamous cell carcinoma (HNSCC). Accessing timely care remains challenging in public health care systems, potentially resulting in disease progression before treatment initiation. A prospective cohort of patients receiving neoadjuvant capecitabine (NC) was compared to stage-matched patients undergoing standard of care (SC). This study was performed at 2 academic centers in Montreal, Canada. To ascertain the effect of 2 cycles of NC in operable HPV-negative HNSCC patients on clinical-to-pathologic stage migration. Comparison to an SC group was performed to site and TNM stage matched patients. Pathologic treatment response was measured using the modified Ryan score. We compared 16 NC patients (11 oral cavity, 3 skin, 2 larynx) with 32 SC patients. Ten NC patients exhibited a pathologic response (1 complete, 3 major, 6 minor). Clinical-to-pathologic stage migration differed significantly between NC and SC groups: downstage (6 vs 1), upstage (3 vs 14), no change (7 vs 17, P = .0047). There was no severe treatment toxicity related to capecitabine. All patients in the NC group underwent surgery. NC followed by surgery demonstrates measurable pathologic response in HPV-negative HNSCC, suggesting potential utility in resource-limited health care settings.

Stereotactic Body Radiotherapy for Renal Cell Carcinoma-A Review of Use in the Primary, Cytoreductive and Oligometastatic Settings.

Renal cell carcinoma (RCC) has been increasing in incidence by around 1.5% per year for several years. However, the mortality rate has been decreasing by 1.6% per year, and this can be attributed to stage migration and improvements in treatment. One treatment modality that has emerged in recent years is stereotactic body radiotherapy (SBRT), which is an advanced radiotherapy technique that allows the delivery of high-dose radiation to the tumor while minimizing doses to the organs at risk. SBRT has developed a role in the treatment of early-stage, oligometastatic and oligoprogressive RCC. In localized disease, phase II trials and meta-analyses have shown that SBRT provides a very high probability of long-term local control with a low risk of severe late toxicity. In oligometastatic (OMD) RCC, the same level of evidence has similarly shown good local control and minimal toxicity. SBRT could also delay the necessity to start or switch systemic treatments. Medical societies have started to incorporate SBRT in their guidelines in the treatment of localized disease and OMD. A possible future role of SBRT involves cytoreduction. It is theorized that SBRT can lower tumor burden and enhance immune-related response, but it cannot be recommended until the results of the phase II trials are published.

Incidence and Dynamics of CRC Stage Migration: A Regional vs. a National Analysis.

Due to an increased rate of surveillance colonoscopy, we aim to determine the impact of stage migration on the incidence and overall survival (OS) of patients who underwent pathological staging of colorectal cancer (CRC) at our Health Network System. Two datasets were included: subjects from the tumor registry at a regional Comprehensive Cancer Center (n = 1385) and subjects from the Surveillance, Epidemiology, and End Results (SEER) national database (n = 202,391). A significant increase in the diagnosis of CRC Stage 1 and 4 was observed, with a decrease in stage 2, and no change in Stage 3 in the National datasets (p < 0.01). There was an increase in Stage 4 CRC diagnosis, with a concurrent decrease in stage 2, and no changes in stages 1 and 3 in the regional dataset (p < 0.05). OS followed the expected and progressive decrease in OS by stage (from 1 to 4, p < 0.01). The present findings confirmed CRC stage migration in our Health Network System, along with a national trend conducive to an increased OS for early CRC stages.

Geodynamic development of structures of the North Absheron uplift zone within the South Caspian megadepression and oil-gas-bearing

The article discusses the geodynamic development of the structures of the North Absheron uplift zone. The Pirallahi-Kelkor trough is a polyfocal sub-basin due to the fact that in its sedimentary section, at least the Jurassic, Lower Cretaceous, Lower Pliocene and Quaternary deposits, are characterized by favorable conditions for the accumulation and burial of organic matter. It follows from this that, in accordance with its paleogeotemperature regime, several main stages of hydrocarbon migration could have taken place here. For identifying the formation and further structural-tectonic development , the Absheron bank, the Arzu, Chilov, Palchig Pilpilasi, Chirag and Garabag uplifts have been studied. To solve this issue, paleoprofiles for the end of the Jurassic, Early Cretaceous, Miocene and Pliocene based on the seismic geological profile across the strike of the Pirallahi-Kelkor trough have been compiled. As a result of these studies we established that the uplifts are of syndepositional origin, formed simultaneously with the sedimentation process. The sedimentation and geotemperature regime of the subbasin play a significant role . İt was found that by the end of the Pliocene, the main oil formation zone (MOFZ) contained sediments from the second half of the Lower Cretaceous to the second half of the Lower Pliocene, and both Lower Cretaceous and Lower Pliocene deposits took part in the main stage of hydrocarbon migration. Finally, the MOFZ currently contains sediments from the tops of the Lower Cretaceous to the bottoms of the Upper Pliocene. As can be seen, the main stage of migration covered both Lower Cretaceous and Lower Pliocene deposits. İn addition, we concluded that the natural reservoirs of local uplifts that formed within the Absheron archipelago, regardless of the time of their formation, could be saturated with hydrocarbons depending on the level of their development, position in the structural-tec- tonic plan and reservoir characteristics of the strata. Due to the fact that the uplifts were formed no later than the Miocene, it was even considered that they began to appear by the end of the earlier Miocene, and that they could have captured hydrocarbons of the Lower and Later Cretaceous period.

Analysis and prediction for dynamic migration behavior of NEPE propellant/liner interface layer full components

The migration behavior of nitrate ester-plasticized polyether (NEPE) propellant components significantly impacts safety. Experimentally observing the migration process is challenging and time-consuming. This study employed molecular dynamics (MD) methods to simulate a molecular model of the NEPE propellant/liner interface layer, enabling the prediction of component migration behavior. We visualized the migration process of all propellant components and studied the interface layer components' migration patterns, diffusion coefficients, and concentration gradient distributions. The contents of migrated components of the propellant and liner at different accelerated aging times at 70 °C were determined using high-performance liquid chromatography (HPLC), and the simulation patterns were compared with experimental observations. The results indicate that the migrated components in the propellant mainly consist of nitrate esters (Nitroglycerin, abbreviated as NG, and Butanetriol Trinitrate, abbreviated as BTTN), stabilizers (NMethylnitroaniline, abbreviated as MNA, and 2-Nitrodiphenylamine, abbreviated as 2-NDPA), and solid component (Hexahydro-1,3,5-trinitro-1,3,5-triazine, abbreviated as RDX). The migration process is primarily dominated by the substantial migration of nitrate esters, which is a key factor contributing to the degradation of propellant performance during storage. The migration process can be divided into three stages: swift migration, steady slow migration, and migration equilibrium. The diffusion coefficients are ranked from most significant to most minor as NG > BTTN > RDX > MNA > 2-NDPA. Three migration stages consistent with the simulation process were observed using HPLC, and the migration behavior of nitrate esters aligned with simulation patterns. Our designed full-component model can qualitatively predict component migration behavior. Additionally, a faster diffusion coefficient does not necessarily lead to a greater amount of migration. We employed MD simulations combined with density functional theory (DFT) calculations to explain this phenomenon and found that intermolecular interactions may influence the diffusion coefficient. At the same time, the migration amount is highly correlated with molecular polarity. Therefore, increasing the molecular polarity difference between easily migrating components and liner materials is a beneficial strategy for slowing the migration process and enhancing the storage safety of propellants.

Splenic flexure adenocarcinoma: A national cohort analysis of extent of surgical resection and outcomes.

The optimal extent of resection for splenic flexure adenocarcinoma remains debated. These tumours straddle the left- and right-sided vasculature with lymphatic drainage in a watershed area; current guidelines recommend either segmental or extended colectomy. We analysed surgical management of splenic flexure tumours and compared outcomes between approaches. The Surveillance, Epidemiology and End Results database was searched for adults with Stage I-III splenic flexure adenocarcinoma, 2004-2019. Of 5238 patients, 55% underwent extended colectomy. Compared to segmental colectomy, these patients were more likely to have advanced stage. On multivariable analysis, age ≤ 65 years remained independently associated with extended colectomy. Although fewer nodes were examined in segmental colectomy (median 14 vs. 16, p < 0.001), the number of positive nodes (both, median 0 [interquartile ratio 0-2], p = 0.20) and the lymph node ratio were similar between cohorts. Surgical approach was not significantly associated with increased positive nodal yield in adjusted analyses. Five-year overall and disease-specific survival were 73% and 84% for segmental and 72% and 83% for extended colectomy (p > 0.4); these remained comparable after adjustment. Nationally, we observed similar rates of segmental and extended colectomy for splenic flexure adenocarcinoma. Extended colectomy was not more common in Stage III disease, indicating lack of stage migration, and was not associated with better oncological outcomes. These observations support current practice involving either approach, which should be tailored to patient-related factors and preferences, while considering technical aspects and quality of life.

460. THE ADDITIONAL VALUE OF CERVICAL ULTRASOUND IN THE DETECTION OF CERVICAL LYMPH NODE METASTASES IN PATIENTS WITH ESOPHAGEAL CANCER

Abstract Background Esophageal cancer patients with cervical lymph node metastases, staged according to the 8th edition of the American Joint Committee on Cancer (AJCC), are considered to have stage IV disease and are generally not eligible for treatment with curative intent. External cervical ultrasound (US) used to be standard in the diagnostic workup for detection of cervical lymph node metastases in the Netherlands, but is no longer included in the esophageal cancer guideline. This study aimed to assess the additional value of US over 18FDG PET-CT for the detection of cervical lymph node metastases in esophageal cancer patients, to reassure justified removal of cervical US from the guideline. Methods This retrospective cohort study included all esophageal cancer patients referred to or diagnosed in the Amsterdam UMC between January 2014 and January 2021. Radiology and multidisciplinary team meeting reports were reviewed to identify patients with suspected cervical lymph node(s). Primary outcome was detection rate of cervical lymph node metastases on ultrasound and/or 18FDG PET-CT. Golden standard was etiology based on Fine Needle Aspiration (FNA). Results This study included 768 patients, with a median age of 66 years. Patients were predominantly male (75.0%) and the majority had an adenocarcinoma (71.9%). On 18FDG PET-CT, 77 patients had suspected cervical lymph nodes. Of those, 39 proved malignant. Seven malignant lymph nodes were missed on 18FDG PET-CT. 18FDG PET-CT had a positive predictive value (PPV) of 50.6%, a negative predictive value (NPV) of 99.0%, a sensitivity of 84.8% and a specificity of 94.7%. Based on US alone, 134 patients had suspected cervical lymph nodes. Of those, 45 proved malignant. One malignant lymph node was missed on US. US had a PVV of 33.6%, a NPV of 99.8%, a sensitivity of 97.8% and a specificity of 87.7%. In total, suspected cervical lymph nodes were documented in 151 patients (19.7%). FNA was conducted in 134 out of 151 patients. Of those, 46 proved malignant. No major complications after FNA were reported. For 21 patients, this resulted in stage migration and changed policy from curative intent to palliative. Conclusion Standard US increases the number of FNA conducted for benign cervical lymph nodes, as the positive predictive value is low (33.6%). However, it does have an additional value as it identifies 15% of cervical lymph node metastases that were not seen on 18FDG PET-CT.

Directing Rat Hair Follicle Stem Cells Toward Neuronal Lineage With Enhanced Trophic Factor Expression.

Hair follicle stem cells (HFSCs) are promising candidates for cell-based therapies in neurodegenerative diseases because of their ability to differentiate into neural lineages and exert paracrine effects in damaged tissues. However, their clinical application faces challenges, particularly in efficiently guiding them toward neural lineages. This study explores using chick embryo extract (CEE) to enhance HFSCs' secretory capacity and neuronal differentiation. HFSCs from rat whisker pads were cultured in growth medium supplemented with either 20% FBS or a combination of 10% FBS and 10% CEE, transitioning to 20% FBS after the first subculture. We conducted gene expression profiling of lineage commitment markers and neurotrophic factors in both experimental groups, alongside morphological assessments and protein expression analyses. CEE supplementation during migration increased neuronal differentiation, evidenced by more cells with neurites and higher MAP2 expression at both the gene and protein levels. CEE also inhibited the expression of PDGFR-α, indicating a suppression of differentiation toward Schwann cells. Furthermore, we observed increased levels of trophic factors such as BDNF and VEGF at passage 3 induced by CEE supplementation. Enhancing the neuronal lineage commitment of hair follicle stem cells (HFSCs) and boosting the expression of trophic and angiogenic factors through short-term CEE preconditioning during their migratory stage presents a compelling approach. This strategy holds great promise in enhancing the effectiveness of stem cell-based therapies for neurological disorders.