Fertility in seasonal-calving pasture-based lactating dairy cows following timed artificial insemination or timed embryo transfer with fresh or frozen in vitro-produced embryos

The objective was to compare pregnancy per service event (P/S) in lactating dairy cows following timed artificial insemination (AI) or timed embryo transfer (ET) using either fresh or frozen in vitro-produced embryos. Oocytes were collected once per week for up to 9 wk using transvaginal ovum pick-up from elite dairy donors (ET-DAIRY; n = 40; Holstein-Friesian and Jersey) and elite beef donors (ET-ELITE-BEEF; n = 21; Angus). Both ET-DAIRY and ET-ELITE-BEEF donors consisted of heifers and cows. In addition, oocytes were collected from the ovaries of beef heifers of known pedigree following slaughter at a commercial abattoir (ET-COMM-BEEF; n = 119). Following in vitro maturation and fertilization, presumptive zygotes were cultured in vitro to the blastocyst stage. Grade 1 blastocysts were either transferred fresh or frozen for on-farm thawing and direct transfer. A total of 1,106 recipient cows (all lactating, predominantly Holstein-Friesian) located on 16 herdlets were blocked based on parity, calving date, and Economic Breeding Index, and randomly assigned to receive AI (n = 243) or ET (n = 863) after estrous synchronization with a 10-d Progesterone-synch protocol. Cows assigned to ET were further randomized to receive fresh (n = 187) or frozen (n = 178) ET-ELITE-BEEF embryos, fresh (n = 169) or frozen (n = 162) ET-DAIRY embryos, or fresh (n = 80) or frozen (n = 87) ET-COMM-BEEF embryos. Pregnancy was diagnosed using transrectal ultrasound on d 32 to 35 after synchronized ovulation and confirmed on d 62 to 65, at which time fetal sex was determined. Pregnancy per service event at d 32 was not different between AI (48.8%) and ET (48.9%) and did not differ between dairy and beef embryos (50.3% vs. 48.1%, respectively). However, P/S was less on d 32 following transfer of frozen embryos (41.6%) compared with fresh embryos (56.1%). Pregnancy loss between d 32 and 62 was greater for ET (15.1%) compared with AI (4.7%), with greater losses observed for frozen beef (18.5%), fresh beef (17.3%), and frozen dairy (19.2%) compared with fresh dairy (6.0%) embryos. Serum progesterone (P4) concentration on d 7 was associated with P/S at d 32 and 62. Cows in the quartile with the least serum P4 concentrations (quartile 1) had less probability of being pregnant on d 32 (33.4%) compared with cows in the 3 upper quartiles for serum P4 (45.7%, 55.6%, and 61.2% for quartile 2, quartile 3, and quartile 4, respectively). Sex ratio (male:female) at d 62 was skewed toward more male fetuses following ET (61.1:38.9) compared with AI (43.2:56.8) and was consistent with the sex ratio among in vitro blastocysts (61.2:38.8). In conclusion, P/S was similar for AI and ET, although pregnancy loss between d 32 and 62 was greater for ET than for AI.

Approach-avoidance biases to self-harm cues in young people with self-harm

BACKGROUND

The urge to self-harm can be likened to craving in addictive behaviours. However, it remains unclear whether cognitive mechanisms involved in craving, such as attentional biases to cues, also underpin the urge to self-harm.

METHODS

A Dot Probe Task was used to investigate attentional biases to self-harm cues in young people aged 16-25 with self-harm. Cues were shown for either 0.2 s or 2 s. Dot Probe Task performance in the Self-harm group (N = 50) was compared with age-matched Healthy Controls (N = 50) and age- and negative-affect (Depression Anxiety Stress Scale-21) matched controls with no self-harm (N = 50).

RESULTS

The Self-harm group showed significantly greater avoidance of self-harm cues than Healthy Controls at 2 s. The Negative Affect group showed significantly less difficulty disengaging from self-harm cues than the Self-harm group and Healthy Controls at 2 s. There were no between-group differences in attentional bias at 0.2 s.

LIMITATIONS

Study limitations that may affect attentional biases in the Self-harm group include not measuring indicators of recovery and recruiting only from the community potentially missing more severe self-harm presentations in clinical settings.

CONCLUSIONS

Avoidance of self-harm cues in young people with self-harm may reflect conflict around self-harm behaviour, consistent with ambivalence models of craving. An ability to disengage from self-harm cues may be a protective factor in young people with higher levels of negative affect who do not self-harm. Whether these attentional biases represent a quantifiable marker of treatment response or susceptibility to relapse in individuals with self-harm remains an area for future investigation.

Stress Response During Rapid Maxillary Expansion in Children

Purpose: To assess the effect of rapid maxillary expansion (RME) on the inflammatory and stress response of patients undergoing orthodontic treatment. Methods: Eighty salivary samples were collected from patients (n=16) during RME at five moments: before the expander placement (T1); 25 minutes after its first activa- tion (T2); seven days after placement, shortly after the patient arrived at the dental clinic (T3); 25 minutes after the appliance activation on day seven (T4) and one month after the last activation of the appliance (T5). Cortisol and nitric oxide levels were evaluated using an immunoassay kit and the Griess method, respectively. Friedman and Wilcoxon tests were used for statistical analysis (P <0.05). Results: Participants' mean age was 11.5 years. There was a significant change in cortisol levels over the study period in the total sample (P<0.01), for the Haas appliance (P=0.01), female sex (P=0.01), younger children (P=0.01), presence of large overbite (P=0.02), presence of posterior crossbite (P =0.006), Class I type occlusion (P=0.02) and mesofacial facial type (P =0.02). Regarding nitric oxide, there was a significant change over the study period in those who wore the Haas appliance (P =0.04). For nitric oxide levels, T1 was significantly higher than T3, T4 and T5 (P <0.05) for those who wore a Haas appliance. Conclusion: The period anticipating the consultation at the waiting reception area was more stressful than the dental procedure in patients undergoing RME. This procedure did not cause alterations in salivary biomarkers related to inflammation.

Association Between Success and Unsuccess Rates on Technical Skills and Physical Qualities in Rugby Players

Purpose: Although physical and technical performance are both fundamental in rugby union teams, the association between these variables in sub-elite players is limited. This study investigated the association between the rate of success and unsuccess in technical skills throughout a season with physical quality variables in sub-elite rugby players. Methods: Twenty-five sub-elite rugby union players (age: 26.4 ± 3.8 years; body mass: 99.68 ± 14.34 kg; height: 1.81 ± 0.07 m) completed the following assessments: (i) broad jump; (ii) 10- and 30-meters sprint speed; (iii) 5-10-5 test; (iv) 1 RM of bench press, chin-up and squat and (v) Yo-Yo fitness test. The rate of success and unsuccess in tackles, attacking rucks and carries were measured during a season. Results: We found that: (i) higher success rates in carries were associated with faster speeds and greater broad jump distance; (ii) higher unsuccess rates in tackles were associated with lower 1 RM chin-up. When controlling for playing position, (iii) higher success rates in carries were associated with 30-meters speed and broad jump distance; (iv) higher success rates in tackles were associated with higher 1 RM chin-up; and (v) higher unsuccess rates in tackles were associated with lower 1 RM chin-up. Conclusions: Success and unsuccess rates in attacking rucks and success in carries were not associated with physical qualities. Therefore, training programs that improve speed, lower limb power and upper limb maximal strength should receive greater attention when seeking to achieve greater success in trying to break the opponent's defensive line and stop the ball carrier.

COVID-19 in older adult residents in nursing homes: factors associated with mortality and impact on functional capacity

Objective

To verify if the functional capacity prior to COVID-19 infection was different between Survivor and Non-survivor older adults. Also, to verify the effect of the isolation period after COVID-19 infection on the functional capacity of the Survivors residing in nursing homes.

Materials and methods

Older adults residing in nursing homes were evaluated 30 days before the COVID-19 outbreak at the site for (i) general health characteristics (obtained from medical records); (ii) gait speed, handgrip strength and 30-s sit-to-stand; (iii) sarcopenia and (iv) estimated muscle mass. Comparisons were made between Survivors and Non-survivors of COVID-19. After the isolation, the Survivors performed the assessments again.

Results

Twenty-one (81 ± 9.3 years) participants tested positive for COVID-19 and participated in the study, 12 survivors. No difference was observed between Survivors and Non-survivors in any of the outcomes evaluated. However, a moderate effect size was observed for handgrip strength, with lower values for the Non-survivors group (- 16%; d = 0.53). The isolation period reduced the number of sit-to-stand repetitions with moderate effect size in the Survivors (p = 0.046, gav = 0.66).

Conclusion

Although the null hypothesis analysis did not find significant differences between the groups, the effect size suggests that older adults residing in nursing homes who died from COVID-19 had lower handgrip strength. In the survivors, the isolation period after COVID-19 infection only negatively impacted the sit-to-stand performance.

Boroxine benzaldehyde complex for pharmaceutical applications probed by electron interactions

RATIONALE

2,4,6-Tris(4-formylphenyl)boroxine (TFPB) is a substituted boroxine containing a benzaldehyde molecule bonded to each boron atom. Boroxine cages are an emerging class of functional nanostructures used in host-guest chemistry, and benzaldehyde is a potential radiosensitizer. Reactions initiated by low-energy electrons with such complexes may dictate and bring new fundamental knowledge for biomedical and pharmaceutical applications.

METHODS

The electron ionization properties of TFPB are investigated using a gas-phase electron-molecule crossed beam apparatus coupled with a reflectron time-of-flight mass spectrometer in an orthogonal geometry. Ionization and threshold energies are experimentally determined by mass spectra acquisition as a function of the electron energy.

RESULTS

The abundance of the molecular precursor cation in the mass spectrum at 70 eV is significantly lower than that of the most abundant fragment C₇ H₅ O⁺ . Twenty-nine cationic fragments with relative intensities >2% are detected and identified. The appearance energies of six fragment cations are reported, and the experimental first ionization potential is found at 9.46 ± 0.11  eV. Moreover, eight double cations are identified. The present results are supported by quantum chemical calculations based on bound state techniques, electron ionization models and thermodynamic thresholds.

CONCLUSIONS

According to these results, the TPFB properties may combine the potential radiosensitizer effect of benzaldehyde with the stability of the boroxine ring.

Are proximal and distal neuromuscular parameters able to predict hip and knee frontal plane kinematics during single-leg landing?

OBJECTIVE

To determine if proximal and distal neuromuscular parameters (EMG amplitude and median frequency - MDF) can predict frontal plane kinematics during single-leg landing.

STUDY DESIGN

Cross sectional study.

SETTING

Laboratory.

PARTICIPANTS

Fifteen participants (7 female) performed six single-leg landings with measures of frontal plane kinematics and EMG obtained 230 ms after first foot contact, totalizing 90 landings.

MAIN OUTCOME MEASURES

(i) 2D hip adduction [hip ADD] and knee frontal plane projection angle [knee FPPA]; (ii) EMG amplitude and MDF of gluteus medius [GMed], tensor fascia latae [TFL], peroneus longus [PL] and tibialis anterior [TA].

RESULTS

We observed that MDF of TA was a significant predictor of hip ADD (p = 0.037; β = -0.049 Hz; R²c = 0.30). Also, MDF of PL was significant predictor of knee FPPA (p = 0.043; β = 0.042 Hz; R²c = 0.37). Hip muscles and EMG amplitude parameters were not considered predictors of frontal plane kinematics.

CONCLUSION

The firing frequency of ankle muscles predicted the variance of hip and knee frontal plane kinematics during single-leg landing.

The influence of task type and movement speed on lower limb kinematics during single-leg tasks

BACKGROUND

Single-leg squats and step-downs are commonly used to assess kinematic variables that may be linked to injuries. Task type and movement speed may influence the outcomes of interest because of different balance requirements.

RESEARCH QUESTION

What is the influence of task type and movement speed on lower limb kinematics?

METHODS

This is a cross-sectional within-subjects study where 22 physically active females performed three single-leg functional tasks (Squat, Anterior step-down, and Lateral step-down) at three movement speeds (slow [5 s], fast [2 s], and self-selected), while three-dimensional kinematic variables were recorded. Displacement values from the initial position in single-leg support until 60° or peak knee flexion were calculated. Two-way repeated measures ANOVA was used to compare tasks and speeds, and Cohen's d effect size (ES) was calculated for significant pairwise comparisons.

RESULTS

At 60°, lateral step-down presented the greatest hip adduction (large ES) and internal rotation (small ES). The anterior step-down had the lowest knee abduction displacement while the squat had the greatest (small to medium ES). At peak knee flexion, values increased but differences between tasks followed a similar pattern. Slow speed induced smaller displacement angles at the knee and hip (trivial to small ES).

SIGNIFICANCE

When knee abduction is the variable of interest, the SLS may be the best test since it elicits the greatest displacement, but when evaluating hip motion, SD_LAT might be best. Knee abduction and internal rotation were lowest in the slow condition, suggesting that faster speed may be more appropriate to detect abnormal movement patterns. However, the small difference in absolute values (i.e., degrees of movement) may indicate that the differences are not clinically significant, particularly for speed comparisons. Researchers and clinicians should take this into consideration when choosing the most appropriate task and the instruction to give during its execution.

O-260 Improved implantation and pregnancy rates in frozen-thawed embryo transfer using a modified-natural ovulatory regimen

Study question

Are the outcomes of pregnancy significant different between modified-natural (mN) cycle frozen-thawed embryo transfer (FET) and hormone terapy (HT) cycle FET?

Summary answer

Implantation and pregnancy rates are significantly higher in mN cycle FET as compared to HT cycle FET.

What is known already

The use of FET has dramatically increased the cumulative pregnancy rate and reduced the cost and time to pregnancy in assisted reproductive technology (ART). Three different regimens can be used to perform FET, the spontaneous ovulatory (natural) cycle; the one in which the endometrium is artificially prepared with HT; and cycles in which ovulation is induced. In our center, for the past three years, we have performed HT cycle FET as well as a modified-natural regimen, which includes the administration of 250 µg recombinant hCG (r-hCG) upon the visualization of one follicle measuring ≥ 18 mm in diameter.

Study design, size, duration

Women undergoing FET post intracytoplasmic sperm injection (ICSI), between Jan/2019 and August/2021 in a private university-affiliated IVF center were included (mN cycle FET group, n = 142 and HT cycle FET group, n = 1180). Generalized linear models adjusted for potential confounders, followed by Bonferroni post hoc were used to compare clinical outcomes between groups.

Participants/materials, setting, methods

In mN cycle FET group, after menses, the endometrial development was monitored, and patients received 250µg r-hCG upon the visualization of one follicle ≥ 18mm in diameter, and 600mg daily of micronized progesterone for five days, until embryo transfer. In HT cycle FET group, after menses the patients received 200µg of transdermal 17 β-estradiol every three days. When endometrium showed proliferative morphology and thickness of at least 7.5mm, 600mg of progesterone was daily administered.

Main results and the role of chance

Mean female age was similar between the groups (36.0 years ± 0.5 for mN cycle FET and 35.6 years ± 0.2 for HT cycle FET groups, respectively). The implantation rate was significantly higher in mN cycle FET group compared to HT cycle FET group (45.3% ± 0.76 vs. 38.6% ± 0.22, p &lt; 0.001, respectively). The pregnancy rate was also significantly higher in mN cycle FET group compared to HT cycle FET group (66.0% vs. 52.4%, p = 0.017, respectively). No significant differences were observed between the groups in miscarriage rate (10.7% for mN cycle FET and 15.7% for HT cycle FET groups, respectively, p = 0.279).

Limitations, reasons for caution

Retrospective nature of this study and the small sample size may be a reason for caution.

Wider implications of the findings

Our study suggests use of an hCG trigger may improve outcomes in natural cycle FET. In patients undergoing FET, triggering ovulation can significantly reduce the number of visits necessary for scheduling embryo transfer without an adverse effect on outcomes. Ovulation triggering can increase both patient convenience and cycle cost effectiveness.

Trial registration number

Not applicable

Emotional Dysregulation and Altered Reward Processing in Self-Harm

Introduction

Self-Harm (SH) is any act of self-injury carried out by somebody irrespective of motivation. SH most commonly functions to relieve negative affect (NA). Tentative evidence suggests reward processing is altered in SH. NA may trigger reward hypersensitivity and therefore SH. Whether NA influences reward processing in SH remains unclear.

Objectives

To investigate whether self-harmers differ in motivation to obtain SH stimuli than healthy controls (HCs) following NA induction.

Hypothesis

After NA induction, SH participants will have a significantly shorter reaction latency (RL) and greater reaction accuracy (RA) than HCs in the SH condition of the Incentive Delay (ID) task.

Methods

16-25-year-old SH (n=35) and HC (n=20) participants were recruited online and underwent the Trier Social Stress Test, to induce NA, followed by the ID task, where participants were cued to respond to a target as quickly as possible. On responding, an image of either a SH act (SH Condition), people socializing (Social Condition) or money (Monetary Condition) appeared. Each condition included control trials showing a neutral image. RA was the percentage of trials responded to within the target’s presentation time. RL was the time (seconds) between target appearance and participants’ response.

Results

There was no significant main effect of group, condition or group x condition interaction for RL. There was a significant main effect of condition (p < 0.05) but not of group nor a group x condition interaction for RA.

Conclusions

Reward processing did not differ in the SH group compared to HCs post-NA induction. Future studies could investigate reward processing in longitudinal and larger SH samples.

Disclosure

No significant relationships.

Impact of a Psychotherapy Protocol on Women with a History of Intimate Partner Violence in Brazil

Violence against women is a public health problem, and it causes psychological damage that should be the focus of psychological treatment. Psychological symptoms include anxiety, depression, and trauma-related stress. Scientific, evidence-based practices are recommended for a high-quality outcome. This study aimed to evaluate the impact of a 16-session Cognitive Behavioral Psychotherapy protocol for women with a history of intimate partner violence (IPV). The final sample included 26 women. The participants were evaluated before the intervention and after the end of it. The study results indicate an increase in the level of life satisfaction, as well as a reduction in anxiety, depression, and trauma-related symptoms. Patients with different histories of violence have benefited from the intervention. Despite the limitations of this study, for example, sample size and the absence of a control group, the results provide initial evidence of the effectiveness of the protocol. This study contributes to stimulating evidence-based practices for treatment for this population in Brazil. Future experimental and follow-up studies are necessary to produce evidence of the effectiveness of the protocol.

Physical and performance indicators between backs and forwards in Tier-3 and Tier-1 Rugby Union Teams

BACKGROUND

Backs and forwards have different physical and performance demands in Rugby Union, which can be modified between teams of different competitiveness level. The aim of study was to compare physical and performance indicators during matches in backs and forwards from a Tier-3 team and to compare with elite teams (Tier-1).

METHODS

Twenty-five professional Rugby athletes (backs; n = 12; forwards, n = 13) from a Tier-3 team were evaluated for: (i) body mass and height; (ii) sprinting speed of 10 meters; (iii) sprint momentum; (iv) 1RM of bench press, chin-up and squat exercises and (v) Yo-yo Fitness Test. Performance indicators during matches (number of passes, carries, tackles, attacking rucks and ball possessions) were evaluated. A Student's t test was used to compare positions and effect size analysis was used to compare the results with Tier-1 teams in published studies.

RESULTS

We found that forwards are taller, heavier, have stronger upper limbs, perform more tackles and participate in more attacking rucks (p<0.05), while backs are faster, have higher sprint momentum, aerobic power and have more ball possessions (p<0.05). Also, we showed that Tier-1 teams are heavier, taller, with greater sprint momentum, have more ball possessions, perform more passes and forwards perform more attacking rucks, while the Tier-3 team performed more tackles.

CONCLUSIONS

This study demonstrated that backs and forwards have different physical characteristics and perform different actions during the matches. Moreover, teams with higher level of competitiveness present advantages in physical capacities and offensive performance indicators compared to sub-elite teams.

Effects of task and hip-abductor fatigue on lower limb alignment and muscle activation

Purpose

Fatigue-induced hip-abductor weakness may exacerbate lower-limb misalignments during different dynamic single-leg tasks. We sought to evaluate the effects of fatigue and task on lower limb kinematics and muscle activation and to find associations between measurements obtained in two tasks.

Methods

One-group pretest–posttest design. Seventeen healthy adults (9 W) performed the single-leg squat (SLSQUAT) and the single-leg hop (SLHOP) before and after a hip-abduction fatigue protocol. Hip adduction, knee frontal plane projection angle (knee FPPA) and heel inversion displacement were measured during the eccentric phase of the SLSQUAT and the SLHOP, as well as activation of the gluteus medius (GMed), tensor fascia latae (TFL), peroneus longus (PER) and tibialis anterior (TA). Moments and tasks were compared using a repeated-measures two-way ANOVA. Correlation between tasks was evaluated using Spearman’s correlation.

Results

No differences in kinematics or activation were found between moments. Hip-adduction displacement (P = 0.005), GMed (P = 0.008) and PER (P = 0.037) activation were higher during SLSQUAT, while TA activation was higher during SLHOP (P < 0.001). No differences were found between tasks in knee FPPA and heel inversion. Hip-adduction and knee FPPA were not correlated between tasks, while ankle inversion displacement was positively correlated (rs = 0.524–0.746).

Conclusion

Different characteristics of SLSQUAT (slower and deeper) seem to have led to increased hip adduction displacement, GMed, and PER activation and decreased TA activation, likely due to higher balance requirements. However, hip-abductor fatigue didn’t influence lower-limb alignment during the tasks. Finally, evaluations should be performed with different single-leg tasks since they don’t give the same lower-limb alignment information.

Does coronary calcium score add value to European SCORE in an asymptomatic population?

Background

Despite being a controversial subject, multiple guidelines mention the use of Coronary Artery Calcification (CAC) scoring in the cardiovascular risk prediction in the asymptomatic population. Adding CAC score to European SCORE (Systematic Coronary Risk Evaluation) may improve the prediction of MACE (Major Adverse Cardiovascular Events), providing better cardiovascular risk stratification.

Purpose

Our study aims to evaluate the impact of CAC severity in MACE prediction compared with SCORE and estimate the additional value of CAC score in cardiovascular risk stratification in a low- risk region and asymptomatic population.

Methods and results

The study consisted of a prospective registry of 1110 asymptomatic individuals free of known coronary heart disease, enrolled from the GENEMACOR study and referred for computed tomography for the CAC scoring assessment. The mean age was 51.6±8.2 years, and 74.1% were male. This population was followed for a mean of 5.2±3.3 years for the primary endpoint of all-cause of cardiovascular events. The extent of CAC differs significantly between men and women in the same age group. Therefore, the distribution of CAC score by age and gender was done using Hoff's nomogram (a). According to this nomogram, 3 categories were created: low CAC (0≤CAC&lt;100 and P&lt;50); moderate CAC (100≤CAC&lt;400 or P50–75) and high CAC (CAC≥400 or P&gt;75). Through a Cox regression for MACE occurrence, SCORE does not remain in the equation, and the higher severity level of CAC presented a significant risk of MACE occurrence with an HR of 7.943 (95% CI 2.948 – 21.401; p&lt;0.0001). Using the C-index, CAC was superior to SCORE (0.729 vs 0.615; p&lt;0.0001). Adding CAC score to SCORE increased MACE prediction compared to SCORE alone (AUC 0.77 vs 0.615; p=0.003).

Conclusion

Our results point to the importance of the CAC score inclusion in primary prevention to improve cardiovascular risk stratification. CAC score in clinical practice could have a prognostic impact on MACE prediction. Larger prospective multicenter cohorts with longer follow-up should reproduce and validate these findings.

Funding Acknowledgement

Type of funding sources: None. Table 1

UNDERWATER ENDOSCOPIC MUCOSAL RESECTION FOR SMALL RECTAL NEUROENDOCRINE TUMORS

BACKGROUND

A common site of neuroendocrine tumors (NETs) is the rectum. The technique most often used is endoscopic mucosal resection with saline injection. However, deep margins are often difficult to obtain because submucosal invasion is common. Underwater endoscopic mucosal resection (UEMR) is a technique in which the bowel lumen is filled with water rather than air, precluding the need for submucosal lifting.

OBJECTIVE

This study aimed to evaluate the efficacy and safety of UEMR for removing small rectal neuroendocrine tumors (rNETs).

METHODS

Retrospective study with patients who underwent UEMR in two centers. UEMR was performed using a standard colonoscope. No submucosal injection was performed. Board-certified pathologists conducted histopathologic assessment.

RESULTS

UEMR for small rNET was performed on 11 patients (nine female) with a mean age of 55.8 years and 11 lesions (mean size 7 mm, range 3-12 mm). There were 9 (81%) patients with G1 rNET and two patients with G2, and all tumors invaded the submucosa with only one restricted to the mucosa. None case showed vascular or perineural invasion. All lesions were removed en bloc. Nine (81%) resections had free margins. Two patients had deep margin involvement; one had negative biopsies via endoscopic surveillance, and the other was lost to follow-up. No perforations or delayed bleeding occurred.

CONCLUSION

UEMR appeared to be an effective and safe alternative for treatment of small rNETs without adverse events and with high en bloc and R0 resection rates. Further prospective studies are needed to compare available endoscopic interventions and to elucidate the most appropriate endoscopic technique for resection of rNETs.

Excited States of Bromopyrimidines Probed by VUV Photoabsorption Spectroscopy and Theoretical Calculations

We report absolute photoabsorption cross sections for gas-phase 2- and 5-bromopyrimidine in the 3.7-10.8 eV energy range, in a joint theoretical and experimental study. The measurements were carried out using high-resolution vacuum ultraviolet synchrotron radiation, with quantum chemical calculations performed through the nuclear ensemble approach in combination with time-dependent density functional theory, along with additional Franck-Condon Herzberg-Teller calculations for the first absorption band (3.7-4.6 eV). The cross sections of both bromopyrimidines are very similar below 7.3 eV, deviating more substantially from each other at higher energies. In the 7.3-9.0 eV range where the maximum cross-section is found, a single and broad band is observed for 5-bromopyrimidine, while more discernible features appear in the case of 2-bromopyrimidine. Several π* ← π transitions account for the most intense bands, while weaker ones are assigned to transitions involving the nitrogen and bromine lone pairs, the antibonding σ*Br orbital, and the lower-lying Rydberg states. A detailed comparison with the available photo-absorption data of bromobenzene is also reported. We have found significant differences regarding the main absorption band, which is more peaked in bromobenzene, becoming broader and shifting to higher energies in both bromopyrimidines. In addition, there is a significant suppression of vibrational structures and of Rydberg states in the pair of isomers, most noticeably for 2-bromopyrimidine.

Electron Driven Reactions in Tetrafluoroethane: Positive and Negative Ion Formation

In the search for alternatives to chlorine-containing gases, tetrafluoroethane, CF₃CH₂F (R134a), a widely used refrigerant gas, has been recognized as a promising substitute for dichlorodifluoromethane, CCl₂F₂ (R12). When R12 is replaced by R134a, the global warming potential drops from 8100 to 1430, the ozone depletion potential changes from 1 to 0, and the atmospheric lifetime decreases from 100 to 14 years. Electron interactions in the gas phase play a fundamental role in the atmospheric sciences. Here, we present a detailed study on electron-driven fragmentation pathways of CF₃CH₂F, in which we have investigated processes induced by both electron ionization and electron attachment. The measurements allow us to report the ion efficiency curves for ion formation in the energy range of 0 up to 25 eV. For positive ion formation, R134a dissociates into a wide assortment of ions, in which CF₃⁺ is observed as the most abundant out of seven ions with a relative intensity above 2%. The results are supported by quantum chemical calculations based on bound state techniques, electron-impact ionization models, and electron-molecule scattering simulations, showing a good agreement. Moreover, the experimental first ionization potential was found at 13.10 ± 0.17 eV and the second at around 14.25 eV. For negative ion formation, C₂F₃^- was detected as the only anion formed, above 8.3 eV. This study demonstrates the role of electrons in the dissociation of R134a, which is relevant for an improvement of the refrigeration processes as well as in atmospheric chemistry and plasma sciences.

Moderate intensity cycling is better than running on recovery of eccentric exercise-induced muscle damage

OBJECTIVE

To compare the effects of moderate intensity running and cycling on markers of exercise-induced muscle damage in men.

STUDY DESIGN

Randomized controlled trial.

SETTING

Laboratory.

PARTICIPANTS

Thirty volunteers were randomized in three groups [running (RG; n = 10), cycling (CG; n = 10) and control (CON; n = 10)] and were evaluated at baseline, post 24, 48 and 72 h of knee extensors' muscle damage protocol. CON performed passive recovery, while RG and CG performed active recovery immediately after the protocol, as well as 24 h and 48 h afterwards.

MAIN OUTCOMES

(i) maximal voluntary isometric contraction (MVIC); (ii) delayed-onset muscle soreness (DOMS); (iii) plasma creatine kinase (CK) and lactate dehydrogenase (LDH) levels.

RESULTS

No group-by-time interaction was found in any outcome evaluated (p > 0.05). All groups presented decreases in MVIC and increases in DOMS (p < 0.001), without differences in CK and LDH. Compared with CON, exercise groups presented likely beneficial effects for LDH, while only CG had a likely beneficial effect for DOMS. Lastly, CG presented likely/very likely beneficial effects for MVIC and DOMS compared to RG.

CONCLUSION

Although the null hypothesis analysis did not find differences, the magnitude-based inference analysis suggested that moderate intensity cycling have likely beneficial effects on knee extensor muscle recovery after eccentric exercise protocol.

Proximal, Local, and Distal Muscle Morphology in Women With Patellofemoral Pain

Objective:

The objective of this study was to compare proximal, local, and distal muscle morphology in women with and without patellofemoral pain (PFP).

Materials and Methods:

Proximal, local, and distal muscle thicknesses (MTs) were obtained with B-mode sonography in healthy (control group [CG], n = 20) and PFP (PFP group, n = 20) women. In addition, muscle mass was measured by the sum of the synergistic MTs. Data were analyzed by independent t-test, Mann-Whitney U test, and effect size.

Results:

PFP women had smaller gluteus medius ( P = .02, d = 0.7), vastus medialis ( P < .01, d = 1.0), and flexor digitorum brevis ( P < .01, d = 1.0) MT and greater gastrocnemius medialis ( P = .04, d = 0.6) MT than CG. Quadriceps muscle mass ( P = .01, d = 0.8) and foot muscle mass ( P = .008, d = 0.9) were smaller, while plantar flexor muscle mass was greater in the PFP group than in CG ( P = .01, d = 0.8).

Conclusion:

PFP women have proximal, local, and distal MT alterations in comparison with CG, which may explain possible changes in muscle strength and functionality.

Perfluoro effect on the electronic excited states of para-benzoquinone revealed by experiment and theory

We report a comprehensive study on the electronic excited states of tetrafluoro-1,4-benzoquinone, through high-resolution vacuum ultraviolet photoabsorption spectroscopy and time-dependent density functional theory calculations performed within the nuclear ensemble approach. Absolute cross section values were experimentally determined in the 3.8-10.8 eV energy range. The present experimental results represent the highest resolution data yet reported for this molecule and reveal previously unresolved spectral structures. The interpretation of the results was made in close comparison with the available data for para-benzoquinone [Jones et al., J. Chem. Phys., 2017, 146, 184303]. While the dominant absorption features for both molecules arise from analogous π* ← π transitions, some remarkable differences have been identified. The perfluoro effect manifests in different ways: shifts in band positions and cross sections, appearance of features associated with excitations to σCF* orbitals, and spectrum broadening by quenching of either vibrational or Rydberg progressions. The level of agreement between experiment and theory is very satisfactory, yet that required the inclusion of nuclear quantum effects in the calculations. We have also discussed the role of temperature on the absorption spectrum, as well as the involvement of core-excited resonances in promoting dissociative electron attachment reactions in the 3-5 eV range.

Untreated sewage contamination of beach sand from a leaking underground sewage system

Thirty people (mostly children) experienced an episode of skin rash days after a sand sifting beach operation at Porto Pim Beach in Faial, Azores during June 2019. An environmental and epidemiologic investigation was conducted to identify the cause of the outbreak of skin rash. The epidemiologic investigation found that some of the patients experiencing symptoms had never entered the beach water. During the pollution period and throughout the epidemiologic investigation, faecal indicator bacteria levels (94 CFU/100 ml for intestinal enterococci and 61 CFU/100 ml for Escherichia coli) in water remained under the limits used for the ninety-five percentile calculation of an Excellent coastal and transitional bathing water defined in the Portuguese Legislation (100 CFU/100 ml for intestinal enterococci and 250 CFU/100 ml for Escherichia coli). Thus sand contact was considered as a likely primary exposure route. Sand microbiological analysis for faecal indicator organisms and electron microscopy strongly suggested faecal contamination. Chemical analysis of the sand also revealed a concomitant substance compatible with sodium-hypochlorite as analysed using gas chromatography and subsequently confirmed by free chlorine analysis. Inspection of the toilet facilities and sewage disposal system revealed a leaking sewage distribution box. Collectively, results suggest that the cause of the outbreak was the leaking underground sewage distribution box that serviced the beach toilet facilities (40 m from beach), where sodium-hypochlorite was used for cleaning and disinfection. This sewage then contaminated the surficial sands to which beach goers were exposed. Chlorine being an irritant substance, was believed to have been the cause of the symptoms given the sudden presentation and dissipation of skin rashes. No gastro-intestinal illness was reported during this episode and during the following 30 days. Like water, beach sand should also be monitored for safety, especially for areas serviced by aged infrastructure.

Sustainable plant polyesters as substrates for optical gas sensors

The fast and non-invasive detection of odors and volatile organic compounds (VOCs) by gas sensors and electronic noses is a growing field of interest, mostly due to a large scope of potential applications. Additional drivers for the expansion of the field include the development of alternative and sustainable sensing materials. The discovery that isolated cross-linked polymeric structures of suberin spontaneously self-assemble as a film inspired us to develop new sensing composite materials consisting of suberin and a liquid crystal (LC). Due to their stimuli-responsive and optically active nature, liquid crystals are interesting probes in gas sensing. Herein, we report the isolation and the chemical characterization of two suberin types (from cork and from potato peels) resorting to analyses of gas chromatography–mass spectrometry (GC-MS), solution nuclear magnetic resonance (NMR), and X-ray photoelectron spectroscopy (XPS). The collected data highlighted their compositional and structural differences. Cork suberin showed a higher proportion of longer aliphatic constituents and is more esterified than potato suberin. Accordingly, when casted it formed films with larger surface irregularities and a higher C/O ratio. When either type of suberin was combined with the liquid crystal 5CB, the ensuing hybrid materials showed distinctive morphological and sensing properties towards a set of 12 VOCs (comprising heptane, hexane, chloroform, toluene, dichlormethane, diethylether, ethyl acetate, acetonitrile, acetone, ethanol, methanol, and acetic acid). The optical responses generated by the materials are reversible and reproducible, showing stability for 3 weeks. The individual VOC-sensing responses of the two hybrid materials are discussed taking as basis the chemistry of each suberin type. A support vector machines (SVM) algorithm based on the features of the optical responses was implemented to assess the VOC identification ability of the materials, revealing that the two distinct suberin-based sensors complement each other, since they selectively identify distinct VOCs or VOC groups. It is expected that such new environmentally-friendly gas sensing materials derived from natural diversity can be combined in arrays to enlarge selectivity and sensing capacity.

Proximal and distal muscle thickness is different in women with patellofemoral pain but is not associated with knee frontal plane projection angle

OBJECTIVE

The aim of this study was to compare proximal and distal muscle thickness between patellofemoral pain (PFP) and asymptomatic women (CG) and to verify the possible association between morphology and lower limb alignment during single leg-squat.

METHODS

Thirty women (PFP, n = 15 and CG, n = 15) performed the following evaluations: (i) muscle thickness of external oblique (EO), gluteus medius (GMed), tensor fascia latae (TFL), peroneus (PER) and tibialis anterior (TA); (ii) knee frontal plane projection angle (FPPA) during single-leg squat.

RESULTS

Compared with the CG, PFP showed: (1) smaller GMed (-10.02%; p = 0.04; effect size = 0.82), greater TFL (+18.44%; p = 0.02; effect size = 0.92) and PER (+14.23%; p = 0.02; effect size = 0.87) muscle thickness and greater knee FPPA during single-leg squat (+31.8%; p = 0.04; effect size = 1.12). No differences were observed in EO (+7.17%; p = 0.37; effect size = 0.34) and TA (-1.35%; p = 0.81; effect size = 0.12) muscle thickness. Additionally, we failed to observe significant associations between muscle morphology and knee FPPA in both groups.

CONCLUSION

PFP patients showed alterations in proximal and distal muscle thickness, despite the lack of association with poor lower limb alignment. Prospective studies are necessary to determine if differences in muscle morphology are the cause or the consequence of PFP and to confirm the absence of relationship with lower limb alignment.

Analysis of the freezing point of milk by precision method and by Fourier Transform Infrared (FTIR) spectroscopy

ABSTRACT A total of 480 milk samples were analyzed in four repetitions with four preservative treatments (no preservative, Bronopol, Bronolat and Brononata), three storage times at temperatures up to 4 °C (24, 48 and 72hours after reception), five different water additions (0.0, 2.5, 5.0, 7.5 and 10.0%) and two analytical instruments (electronic cryoscope and FTIR). The objective of this study was to evaluate the effect of these parameters in the determination of the freezing point by the reference method and by Fourier transform infrared spectroscopy, thus determining the best analytical conditions and establishing a mathematical equation for electronic determination by FTIR spectroscopy. Bronolat was the best preservative and Brononata was the worst and is not recommended to analyze freezing point by FTIR. The storage time of the samples did not interfere in the analytical determinations by the precision method and by FTIR.

Core muscles thickness is not associated with knee frontal plane projection angle during single-leg squat in healthy people

BACKGROUND

Core muscles play an important role in lower limb stability and alignment, with their weakness being associated with poor alignment and, consequently, with injuries. Despite muscle structure being critical to muscle strength production, we did not find studies associating the morphology of the core muscles and lower limb alignment during functional tasks.

RESEARCH QUESTION

Is there association between thickness of core muscles (external oblique - EO, internal oblique - IO, transversus abdominis - TrA and gluteus medius - GMed) and lower limb alignment during the single-leg squat in healthy subjects?

METHODS

Forty-six healthy participants (27 male and 19 female) performed the following evaluations: (i) measurements of muscle thickness of the EO, IO, TrA and GMed using ultrasound and (ii) measurements of lower limb alignment using the knee frontal plane projection angle (FPPA) during the single-leg squat. A Spearman rank correlation coefficient (r_s) was performed between the thickness of selected core muscles (OE, OI, TrA and GMed) and the knee FPPA. In addition, a partial correlation (r) was performed, using sex, physical activity level and body mass index as control variables.

RESULTS

We did not observe significant correlations between the knee FPPA and the thickness of the EO (r_s = 0.194; p = 0.197), IO (r_s = 0.182; p = 0.225), TrA (r_s = 0.073; p = 0.627) and GMed (r_s = -0.092; p = 0.542). When controlling for sex, physical activity level and body mass index, similar results were observed [EO (r = 0.157; p = 0.316), IO (r = 0.261; p = 0.092), TrA (r = 0.030; p = 0.850) and GMed (r = -0.144; p = 0.356)] SIGNIFICANCE: Our results demonstrated that core muscles' thickness is not associated with lower limb alignment during the single-leg squat in healthy people.

AB0561 AUTOMATIC QUANTIFICATION OF INTERSTITIAL LUNG DISEASE FROM CHEST COMPUTED TOMOGRAPHY IN SYSTEMIC SCLERODERMA

Background:

Scleroderma-associated interstitial lung disease (SSc-ILD) is often observed in patients with systemic scleroderma (SSc) and its diagnosis contributes to early treatment decisions1,2.

Objectives:

The present study aims to automatically quantify SSc-ILD from high-resolution chest-computed tomography (HRCT) and to evaluate the association between interstitial lung disease (ILD) extension and lung function impairment.

Methods:

Ninety-four patients with SSc and 27 lung-healthy subjects matched for gender, weight, height, and age underwent HRCT, spirometry and carbon monoxide diffusion capacity (DLCO). SSc-ILD was determined as the tissue mass present between -500 and +100 Hounsfield Units normalized by the total lung tissue mass (TLM). Cut off was the highest value obtained in the control group (25% of TLM). All data are presented as mean and standard deviations (Table I). An ANOVA test followed by Bonferroni post-hoc correction was used for comparisons among groups.

Results:

From 94 patients with SSc, 64 were classified as having pulmonary involvement (SSc-ILD) and 30 as not having pulmonary involvement (SSc No-ILD). In SSc-ILD subjects, there was a significant reduction in forced vital capacity (FVC), carbon monoxide diffusion capacity (DLCO) and carbon monoxide diffusion capacity normalized by alveolar ventilation (DLCO/A) when compared with SSc No-ILD and control group.

Conclusion:

The proposed method allows the automatic quantification of SSc-ILD from HRCT and ILD extent is associated with pulmonary function impairment.

References:

[1]Doyle TJ, Dellaripa PF. Lung Manifestations in the Rheumatic Diseases. CHEST. 2017 Dec;152(6):1283–95.

[2]Saketkoo LA, Magnus JH, Doyle MK. The primary care physician in the early diagnosis of systemic sclerosis: the cornerstone of recognition and hope. The American Journal of the Medical Sciences. 2014 Jan;347(1):54–63.

Table 1.

Demographic variables, pulmonary function tests and densitovolumetry considering scleroderma patients with less or greater pulmonary involvement.

Control GroupN = 27SSc No-ILDN = 30SSc-ILDN = 64p-valueDemographic DataFemales16 (59.2)28 (93.3)58 (90.1)-Age (years)37.9 ± 14.851.2 ± 12.256 ± 14<0.011a,bBMI (kg/m2)26.7 ± 5.124.1 ± 5.025.9 ± 5.7-Lung Function FVC (% predicted)100.2 ± 9.299.9 ± 19.869.8 ± 16.7<0.001b,c DLco (% predicted)103 ± 13.383.8 ± 14.263.4 ± 20.3<0.002a,b,cDLco/A (% predicted)112.7 ± 17.485.7 ± 12.979.2 ± 20.6<0.001a,bDensitovolumetryTLV mL4675 ± 9864471 ± 9163492 ± 1120<0.001b,cLung Tissue Mass (g)793 ± 125756 ± 159731 ± 155- ILD Extent (% LTM)17 ± 222.9 ± 1.232.6 ± 8<0.003a,b,c

a: Statistically significant difference between No-ILD SSc and control group; b and c: Statistically significant difference between SSc-ILD vs control group and SSc No-ILD, respectively.

Disclosure of Interests:

None declared

Quadriceps muscle properties in rheumatoid arthritis: insights about muscle morphology, activation and functional capacity

BACKGROUND

Rheumatoid arthritis (RA) is an inflammatory and chronic autoimmune disease that leads to muscle mass loss and functional capacity impairment, potentiated by physical inactivity. Despite evidences demonstrate neuromuscular impairments in RA patients, aging effects may have masked the results of similar previous studies. The aim of study was to verify (i) the effects of RA on functional capacity and muscle properties in middle-aged patients and (ii) the association between age, clinical characteristics, quadriceps muscle properties and functional capacity.

METHODS

Thirty-five RA women and 35 healthy age-matched women were compared with the following outcomes: (i) physical activity level through the International Physical Activity Questionnaire (IPAQ); (ii) timed-up and go (TUG) test; (iii) isometric knee extensor muscular strength; and (iv) vastus lateralis muscle activation and muscle architecture (muscle thickness, pennation angle and fascicle length) during an isometric test. An independent Student t-test and partial correlation (controlled by physical activity levels) were performed, with p < 0.05.

RESULTS

Compared with healthy women, RA presented (i) lower physical activity level (- 29.4%; p < 0.001); (ii) lower isometric knee extensor strength (- 20.5%; p < 0.001); (iii) lower TUG performance (- 21.7%; p < 0.001); (iv) smaller muscle thickness (- 23.3%; p < 0.001) and pennation angle (- 14.1%; p = 0.011). No differences were observed in muscle activation and fascicle length. Finally, the correlation demonstrated that, with exception of TUG, muscle strength and muscle morphology were not associated with age in RA, differently from healthy participants.

CONCLUSION

Middle-aged RA patients' impairments occurred due to the disease independently of the aging process, except for functional capacity. Physical inactivity may have potentiated these losses.

Comparison between 4 weeks passive static stretching and proprioceptive neuromuscular facilitation programmes on neuromuscular properties of hamstring muscles: a randomised clinical trial

Background/aims

Studies have shown the efficacy of stretching to increase the hip flexion range of motion but studies regarding its effects are not unanimous about the most efficient technique. The aim of this study was to compare the effect of two stretching techniques on the neuromuscular properties of the hamstring muscles.

Methods

A total of 18 women (aged 24 ± 2.52 years old) participated, and were divided into three groups: a control group, a passive static stretching group and a propioceptive neuromuscular facilitation stretching group. Evaluations of variables of the hamstring muscles were performed before and after the training period. The intervention was carried out for 30 seconds, three times a week for a total of 4 weeks.

Results

A significant difference was found in the range of motion in the passive static stretching group (pre=80.8° [±11.0] and post=94.5° [±10.2]; t(5)=−3.755; P=0.013) and in concentric torque (passive static stretching group – pre=66.3 Nm [±12.9] and post=70.0 Nm [±8.1]; t(5)=−1.267; P=0.023; propioceptive neuromuscular facilitation stretching group – pre=79.1 Nm [±12.7] and post=83.5 Nm [±11.6]; t(5)=−1.917; P=0.014; control group – pre=71.1 Nm [±10.1] and post=74.1 Nm [±14.6]; t(5)=−1.275; P=0.003).

Conclusions

Passive static stretching was superior to propioceptive neuromuscular facilitation when comparing the increase range of motion in hip flexion, even without neural and structural changes in hamstring muscles after a 4-week period.

Impacts of subclinical hypocalcemia on physiological, metabolic, and productive responses of Holstein × Gir dairy cows

This study compared physiological and productive parameters in ¾ Holstein × ¼ Gir dairy cows diagnosed or not with subclinical hypocalcemia (SCH) during early lactation. Nonlactating, multiparous cows (n = 32) were enrolled in this experiment 21 d prior to expected date of calving. Cows were maintained in a single pen with ad libitum access to corn silage before calving and received a limit-fed prepartum concentrate. Cow body weight (BW) and body condition score (BCS) were recorded weekly, and blood samples were collected on days −21, −14, −9, −6, and −3 relative to expected calving. After calving (day 0), cows were managed in a single pen with ad libitum access to a total mixed ration, and were milked twice daily. Cow BW and BCS were recorded upon calving and then weekly. Milk production was recorded daily and milk samples collected weekly until 30 d in milk (DIM). Blood was collected during the first 5 DIM, and at 6, 9, 16, 23, and 30 DIM. Cows were classified with SCH when mean total serum Ca during the first 5 DIM was ≤2.125 mmol/L. Cows diagnosed with SCH (n = 11) had less (P ≤ 0.04) mean BCS (2.85 vs. 3.07; SEM = 0.07) and less concentrations of serum insulin (0.396 vs. 0.738 ppmol/L; SEM = 0.115) and insulin-like growth factor I (35.9 vs. 57.9 ng/mL; SEM = 4.2), and these outcomes were noted since 21 d prior to expected calving. Cows diagnosed with SCH had greater (P < 0.01) serum concentrations of cortisol at calving (30.2 vs. 22.4 ng/mL; SEM = 2.0), serum haptoglobin at 3 and 6 DIM (0.453 vs. 0.280 mg/mL on day 3 and 0.352 vs. 0.142 mg/mL on day 6; SEM = 0.046), and tended (P = 0.09) to have greater mean concentrations of nonesterified fatty acids from calving to 30 DIM (0.368 vs. 0.304 μEq/L; SEM = 0.026). No differences were detected (P ≥ 0.41) for cow BW and milk production. Cows diagnosed with SCH had less (P = 0.05) mean concentrations of milk total solids (13.2 vs. 13.8 %; SEM = 0.21), tended to have less (P ≤ 0.10) mean concentrations of milk fat (4.34 vs. 4.81 %; SEM = 0.20), protein (3.31 vs. 3.45 %; SEM = 0.05), and lactose (4.45 vs. 4.55 %; SEM = 0.04), and had greater (P = 0.02) milk somatic cell count during the initial 14 DIM (504 vs. 140 cells/μL; SEM = 90). Collectively, Holstein × Gir cows diagnosed with SCH upon calving had altered periparturient physiological parameters denoting reduced energy nutritional, increased milk somatic cell count, and less concentration of milk components during early lactation compared with normocalcemic cows.

P1756 Predictors of outcome in mitral valve repair surgery

Background

Surgical mitral valve repair currently remains a good option in both organic or functional mitral valve regurgitation (MVR). However, a significant number of patients (P) have comorbidities that can contribute to adverse outcomes.

Objective

To determine clinical and echocardiographic predictors of adverse outcomes in P submitted to MV repair surgery in our center, notably MVR recurrence and new MV replacement surgery or all-cause mortality.

Methods

Retrospective analysis of 262 P who underwent MV repair surgery between 2008 and 2017, with a mean follow-up of 30 months. P were included with both organic or functional MV regurgitation. P who underwent simultaneous coronary artery bypass grafting (CABG), atrial fibrillation (AF) surgery and tricuspid valve repair were also included. However, P with simultaneous surgical aortic valve replacement or previous endocarditis were excluded and the remaining 204 P were analysed.

We evaluated whether MVR etiology, simultaneous surgery (tricuspid valve repair, AF or CABG), body mass index (BMI), gender, chronic obstructive pulmonary disease (COPD), diabetes mellitus, renal dysfunction (measured by serum creatinine levels), baseline left ventricular ejection fraction (LVEF) and left ventricle end-diastolic diameter (LVED) were predictors of a composite endpoint (follow-up MV replacement surgery or all-cause mortality) and secondary endpoints: MV replacement surgery and all-cause mortality.

Results

204 P who underwent MV repair surgery, 67.2% male, mean age of 62 ± 14 years. 80.4% had organic MVR and 19.6% functional MVR (mostly ischemic – 72.4%). 7P (3.4%) had rheumatic MVR. 16.8% underwent simultaneous CABG, 12.3% tricuspid valve repair and 7.8% AF ablation. 30-day mortality was 0%.

The composite endpoint occurred in 40P (20%) and there was MVR recurrence with follow-up MV replacement surgery in 15P (7.5%) and all-cause mortality in 28P (13.7%).

The authors found that elevated serum creatinine levels (OR 4.66; p = 0.003), COPD (OR 3.00; p = 0.035) and functional etiology (OR 2.22; p = 0.049) were predictors of the composite endpoint.

Both COPD (OR 2.823; p = 0.024) and renal dysfunction (OR 6.901; p = 0.001) were also found to be independent predictors of all-cause mortality.

Simultaneous CABG was a predictor of all-cause mortality (OR 2.82; p = 0.024).

Female gender was a predictor of future MV replacement surgery (13.4% vs 4.7%, p = 0.023).

However, echocardiographic variables (baseline LVEF and LVED) were not found to be significant predictors of adverse outcomes in MV repair surgery. Likewise, simultaneous AF or tricuspid valve surgery, rheumatic/ischemic etiology, high BMI or diabetes were not associated with poorer prognosis.

Conclusion

In P undergoing MV repair surgery, renal dysfunction and COPD were independent predictors of all-cause mortality. Functional etiology and simultaneous CABG surgery were also predictors of adverse outcomes.

Baseline LVEF and LVED were not correlated with prognosis.

P1755 Clinical and echocardiographic outcomes of mitral valve repair surgery

Background

Mitral valve regurgitation (MVR) represents the second most frequent valvular heart disease. MV surgical repair is often the preferred treatment when MV anatomy is suitable.

Purpose

To characterize the population who underwent MV repair surgery and evaluate the outcomes of residual MVR, allcause mortality and functional classification.

Methods

Retrospective analysis of 262 patients (P) admitted between 2008 and 2017 for MV repair surgery. P who undergone simultaneous coronary artery bypass graft (CABG) surgery, atrial fibrillation (AF) surgery and tricuspid valve repair were also included. P with endocarditis, P who underwent simultaneous aortic valve replacement and P with rheumatic predominant MV stenosis were excluded, the remaining 204 P were analysed. Clinical and echocardiographic characteristics were evaluated in a mean follow-up of 30 months.

Results

204 P, 67.2% male, mean age 62 + 14 years. The most frequent etiology was organic (80.4%), mostly of degenerative cause. Functional etiology was present in 19.6%, mostly ischemic (72.4%). 16.8% underwent simultaneous CABG, 12.3% tricuspid valve repair and 7.8% AF ablation.

Hypertension was significantly associated with functional etiology (90% vs 72.8%, p = 0.022), as well as hypercholesterolemia (80% vs 48.2%, p &lt; 0.001) and diabetes mellitus (32.5% vs 10.4%, p &lt; 0.001). Baseline left ventricular ejection fraction (LVEF) was &gt;50% in 78.4%, reduced (30-50%) 18.1% and poor (&lt;30%) in 3.4%.

Functional etiology was significantly associated with LVEF &lt;50% (70% vs 9.1%, p &lt; 0.001).

161P (78.9%) had MV prolapse: 120P (74.5%) posterior, 29P (18%) anterior and 7.4% (12P) of both leaflets. P2 was the most frequently involved scallop, in 92P (57.1%), followed by P3, in 41P (25.4%). There was MV chordae rupture in 94P (58.3%).

Post-surgery echocardiography revealed that 93.8% had mild or no residual MVR.

30-day mortality rate was 0%.

There was MVR recurrence with MV replacement surgery in 15P (7.5%), mean time 37.1 months. All-cause mortality was registered in 28P (13.7%), with a mean time of 43.7 months after MV surgery.

Of the P without MVR recurrence or mortality, 111P (70%) were in NYHA class I, 41P (26%) in NYHA class II and 6P (4%) in NYHA class III. 6P were lost to follow-up. Upon echocardiographic revaluation there was no residual MVR in 53P (39%), mild MVR in 67P (49%) and moderate MVR in 16P (11.8%).

Conclusion

In P who underwent MV repair surgery, there was 7.5% recurrence rate with follow-up MV replacement surgery and an all-cause mortality of 13.7%. In a mean follow-up of 30 months, 70% of P were in NYHA I class and there was none or mild residual MVR in 88% of P.

The molecular structure and multifunctionality of the cryptic plant polymer suberin

Suberin, a plant polyester, consists of polyfunctional long-chain fatty acids and glycerol and is an intriguing candidate as a novel antimicrobial material. We purified suberin from cork using ionic-liquid catalysis during which the glycerol bonds that ensure the polymeric nature of suberin remained intact or were only partially cleaved—yielding the closest to a native configuration reported to date.

The chemistry of suberin, both in situ (in cryogenically ground cork) and ex situ (ionic-liquid extracted), was elucidated using high-resolution one- and two-dimensional solution-state NMR analyses. Centrifugation was used to isolate suberin particles of distinct densities and their monomeric composition, assembly, and bactericidal effect, inter alia, were assessed.

Analysis of the molecular structure of suberin revealed the relative abundance of linear aliphatic vs. acylglycerol esters, comprising all acylglycerol configurations and the amounts of total carbonyls (C Created by potrace 1.16, written by Peter Selinger 2001-2019 ]]>O), free acid end groups (COOH), OH aliphatics, and OH aromatics. Suberin centrifuged fractions revealed generic physiochemical properties and monomeric composition ​and self-assemble into polygonal structures that display distinct degrees of compactness when lyophilized. Suberin particles—suberinsomes—display bactericidal activity against major human pathogenic bacteria.

Fingerprinting the multifunctionality of complex (plant) polyesters such as suberin allows for the identification of novel polymer assemblies with significant value-added properties.

In-depth analysis of the replication cycle of Orpheovirus

Background

After the isolation of Acanthamoeba polyphaga mimivirus (APMV), the study and search for new giant viruses has been intensified. Most giant viruses are associated with free-living amoebae of the genus Acanthamoeba; however other giant viruses have been isolated in Vermamoeba vermiformis, such as Faustovirus, Kaumoebavirus and Orpheovirus. These studies have considerably expanded our knowledge about the diversity, structure, genomics, and evolution of giant viruses. Until now, there has been only one Orpheovirus isolate, and many aspects of its life cycle remain to be elucidated.

Methods

In this study, we performed an in-depth characterization of the replication cycle and particles of Orpheovirus by transmission and scanning electron microscopy, optical microscopy and IF assays.

Results

We observed, through optical and IF microscopy, morphological changes in V. vermiformis cells during Orpheovirus infection, as well as increased motility at 12 h post infection (h.p.i.). The viral factory formation and viral particle morphogenesis were analysed by transmission electron microscopy, revealing mitochondria and membrane recruitment into and around the electron-lucent viral factories. Membrane traffic inhibitor (Brefeldin A) negatively impacted particle morphogenesis. The first structure observed during particle morphogenesis was crescent-shaped bodies, which extend and are filled by the internal content until the formation of multi-layered mature particles. We also observed the formation of defective particles with different shapes and sizes. Virological assays revealed that viruses are released from the host by exocytosis at 12 h.p.i., which is associated with an increase of particle counts in the supernatant.

Conclusions

The results presented here contribute to a better understanding of the biology, structures and important steps in the replication cycle of Orpheovirus.

Relationship between sleep patterns and multimorbidity in the Canadian Longitudinal Study on Aging

Background

Sleep difficulties are an unmet public health problem, affecting large segments of the population around the world. Poor sleep quality and reduced sleep duration impact over half of older adults and are associated with adverse health outcomes like multiple chronic diseases (multimorbidity) and reduced longevity.

Methods

A cross-sectional analysis of the Canadian Longitudinal Study on Aging (CLSA), a national health survey of community-dwelling adults and older adults. A total of 30,011 participants had physiological and psychosocial data collected at baseline. Sleep measures included self-reported sleep duration (short: &lt;6 hours, normal: 6-8 hours, long: &gt;8 hours) and sleep quality (dissatisfied/very dissatisfied, neutral, satisfied/very satisfied). To capture multimorbidity, a primary definition was operationalized with 17 chronic conditions, whereas a secondary definition was operationalized with 9 chronic conditions to capture both the primary care and public health perspective.

Results

In our sample, 50.9% were female (average age: 62.7 years) and 49.1% were male (average age: 63.2 years). The majority reported a normal sleep duration and approximately half reported being either satisfied or very satisfied with sleep quality. About 70% were living with multimorbidity using the primary care definition (females: 71.7%; males 64.3%), while about 30% were living with multimorbidity using the public health definition (females: 34.8%; males: 28.9%). The adjusted analyses indicated the odds of multimorbidity increased for those who reported short or long sleep duration, as well as dissatisfaction with sleep quality, across age groups and both females and males.

Conclusions

Disrupted sleep may be an additional behavioural risk factor for a number of chronic diseases, in the context of aging populations. It is necessary to understand the potential impact of sleep on the risk of multimorbidity, and this research will build knowledge in this important area.

Key messages

This research will utilize a national health survey to examine and report the characteristics of sleep quality and sleep duration among approximately 30,000 community-dwelling adults in Canada. This research will explore relationships between sleep duration, sleep quality and multimorbidity (controlling for confounding factors) among community-dwelling adults in Canada.

Sleep and Mental Health Among Older Adults in the Canadian Longitudinal Study on Aging

Background

Global studies have demonstrated consistent associations between sleep problems and mental health and well-being in older adults, however Canadian data are lacking. We investigated associations between sleep quantity and quality with both mental illness symptoms and well-being among older adults in Canada.

Methods

We used cross-sectional baseline data from the Canadian Longitudinal Study on Aging, a national survey of 30,097 community-dwelling adults aged 45 years and older. Self-reported sleep measures included average past-week sleep duration (short [&lt;6h], normal [6-8h], long [&gt;8h]), and sleep quality (satisfied or dissatisfied vs neutral). Mental illness outcomes included depressive symptoms and psychological distress. Mental well-being outcomes included self-rated mental health and satisfaction with life. We used modified Poisson regression models with adjustment for sociodemographic, behavioural, and clinical factors, and stratification by sex and age to explore effect modification.

Results

In the unadjusted analysis, short and long sleep duration and sleep dissatisfaction were associated with higher mental illness symptoms and lower well-being across all outcomes. Sleep satisfaction was associated with a lower likelihood of mental illness symptoms and better well-being. Short sleep duration was associated with the largest effects on mental health outcomes. Self-rated mental health and depressive symptoms had the largest associations with sleep measures. Effects were larger in males and the 45 to 54 year age group.

Conclusions

Preliminary evidence suggests sleep duration and quality are associated with symptoms of depression, psychological distress, and poor mental well-being among older adults. We are unable to determine whether sleep problems are a cause or consequence of poor mental health. Nonetheless, sleep may be an important target for public health initiatives to improve mental health and well-being among older adults.

Key messages

Our findings contribute further evidence that sleep difficulties are associated with adverse health outcomes including higher mental illness symptoms and lower well-being among older adults. Sleep disturbances are an unmet public health problem, and may be an important target for public health initiatives to improve mental health and well-being among older adults.

P2486The association between genetic variant ZNF259 and decreased kidney function in the diabetic patients

Aim

Investigate whether the reduction of GFR is a direct consequence of T2D or there are other genetic mechanisms involved in the pathophysiology of the evolution to chronic kidney disease.

Methods

Cross-sectional study with a total of 2579 individuals was performed, of which 735 patients had T2D. Subjects were classified as `'diabetic” if they were taking oral anti-diabetic medication or insulin or if their fasting plasma glucose was higher than 7.0 mmol/l or 126 mg/dl. Within the diabetic group, we considered those with (n=63) and without (n=627) decreased GFR. GFR was calculated through the Cockcroft and Gault formula and decreased GFR was defined as GFR<60 ml/min/1.73m2. Twenty-four genetic variants associated with T2D, metabolic syndrome, dyslipidemia and hypertension were investigated for its impact on GFR, namely: MTHFR 677 and 1298; MTHFD1L; PON 55, 192 and 108; ATIR A/C; AGT M235T; ACE I/D; TCF7L2; SLC30A8; MC4R; ADIPOQ; FTO; TAS2R50; HNF4A; IGF2BP2; PPARG; PCSK9; KIF6; ZNF259; LPA; APOE; PSRS1. Risk factors for decreased GFR were also evaluated (essential hypertension, glycaemia >120 mg/ml, dyslipidemia, alcohol consumption, CAD diagnosis). A logistic regression was performed firstly with the risk factors solely; and secondly adding the genetic variants in order to evaluate the independent predictors of progression to renal failure in T2D.

Results

After the first multivariate logistic regression with all the risk factors for decreased GFR, only CAD remained in the equation, showing to be an independent risk factor for progression to renal failure, in T2D (OR=4.17; 95% CI: 1.64–10.59; p=0.003). In the second logistic regression, including risk factors and the genetic variants, only ZNF259 rs964184 showed an independent and significant association with the risk of decreased GFR (OR=3.03; 95% CI: 1.06–8.70; p=0.039).

Conclusion

This study shows that the variant ZNF259 rs964184 is associated with decreased kidney function, independently of other risk factors. This finding needs further investigation to clarify the genetic mechanism behind the association of rs964184 with decreased GFR, in Type 2 diabetes.