Refining dietary metabolisable energy and crude protein levels in relation to duck performance and behaviour

1. The study evaluated the effect of dietary metabolisable energy (ME) content and crude protein (CP) level on the growth performance and behaviour of ducks.2. A total of 720, Cherry Valley ducks were allocated to 36 pens in groups of 20 birds. For the initial period, from 1 to 21 d age, six diets, containing a standard (SME), low (LME) and high (HME) ME of 12.14, 11.93 and 12.35 MJ/kg, and standard (SCP) or high (HCP) CP contents of 210 or 220 g/kg diet, respectively, were mixed. For the period from 22 to 42 d age, the diets contained ME of 12.98 (SME), 12.77 (LME), 13.19 (HME) MJ/kg and the levels of CP were 170 (SCP) or 180 (HCP) g/kg, respectively.3. An ME by CP interaction was seen from 1 to 21 d age in ducks fed HME + HCP diet, which had greater weight gain than those fed LME + SCP (P < 0.05). Compared to LME + SCP, dietary HME decrease feeding but increased walking behaviour compared to LME + SCP and SME + SCP (P < 0.05). High CP in LME and SME diets increased drinking behaviour (P < 0.05), but there was no change in HME diet. Compared to LME, feeding HME reduced ground pecking (P < 0.05). Feeding HME reduced feeding behaviour (P < 0.05) from 22 to 42 d age. During the same period, standing behaviour was reduced in HCP + LME (P < 0.05). Drinking was reduced in LME + SCP compared to SME + HCP and HME + HCP (P < 0.05).4. A diet formulated with HME and HCP is effective for enhancing growth performance of ducks aged 1-21 d and saving time for feeding or ground pecking, which may induce spending more time on other activities.

Determinants of Quality of Life (QoL) in Female Caregivers in Elderly Care Facilities in Korea

BACKGROUND

The purpose of this study was to analyze the effects of general characteristics, fatigue, depression, self-efficacy, job stress and interpersonal relationships on the quality of life (QoL) of caregivers in nursing hospitals and use them as basic data for intervention programs to improve the quality of life of caregivers.

METHODS

The participants in the study were 137 caregivers, aged 52-76, who were actively working in nursing hospitals. Data were collected from caregivers by visiting 9 hospitals in 6 cities, with a questionnaire of fatigue, depression, self-efficacy, job stress, interpersonal relationship, quality of life.

RESULTS

Age, marriage, marital satisfaction, education, education experience of QoL, monthly income, perceived economic status, hobby or leisure activity, and number of disease showed differences in the degree of QoL at a statistically significant level. In stage 1, economic status (β = -0.18, p = 0.033) and hobby or leisure activity (β = 0.19, p = 0.025) were influencing factors (F = 4.58, p < 0.001). In stage 2, monthly income (β = -0.19, p = 0.034) and perceived economic status (β = -0.18, p = 0.035) were influencing factors. In stage 3, age (β = -2.80, p = 0.006), perceived economic status (β = -2.41, p = 0.017), self-efficacy (β = 3.19, p = 0.002) and interpersonal relationship (β = 7.12, p < 0.001) were influencing factors which showed 61.5% explanatory power (F = 12.88, p < 0.001). Since the subject's fatigue, depression, and stress did not affect the quality of life, further research is needed.

CONCLUSIONS

In order to improve the quality of life of caregivers, it would be necessary to develop interventions for raising their self-efficacy and interpersonal relationship by considering their degree of economic status, hobby or leisure activity, monthly income, and age.

Effect of high-speed sintering on the marginal and internal fit of CAD/CAM-fabricated monolithic zirconia crowns

This study compared the marginal and internal fit of zirconia crowns fabricated using conventional and high-speed induction sintering. A typodont mandibular right first molar was prepared and 60 zirconia crowns were fabricated: 30 crowns using conventional sintering and 30 crowns using high-speed sintering. We presented a new evaluation methodology to measure the marginal and internal fit of restorations through digital scanning, aligning the two datasets, and measuring the distance between two arbitrary point sets of the datasets. For the marginal fit, we calculated the maximum values of the shortest distances between the marginal line of the prepared tooth and that of the crown. The calculated values ranged from 359 to 444 μm, with smaller values for the high-speed sintered crowns (P < 0.05). For the internal fit, we employed mesh sampling and computed the geodesic distances between the prepared tooth surface and the crown intaglio surface. The measured values ranged from 177 to 229 μm with smaller values for the high-speed sintered crowns, but no significant difference was found (P > 0.05). Based on our results, the high-speed sintering method can be considered a promising option for single-visit zirconia treatment in dental practice.

The Mediating Effects of Social Networks and Wisdom on the Relationship between Lifestyle Habits and Healthy Aging in Older Adults with Chronic Diseases

BACKGROUND

The purpose of this study was to analyze the mediating effects of social networks and wisdom on the relationship between lifestyle habits and healthy aging in older adults with chronic diseases.

METHODS

Participants were 120 community-dwelling older adults aged 65 and older with at least one chronic disease. Data were collected from elderly people by visiting nursing care worker training centers, senior centers, social gatherings, and home welfare centers in D, G, and S cities, with a questionnaire of lifestyle habits, social networks, wisdom and healthy aging, and general characteristics.

RESULTS

There were differences in the degree of healthy aging according to age (F = 3.76, p = 0.026), spousal relationship (t = 3.11, p = 0.002), education (F = 9.08, p < 0.001), number of diseases (F = 8.65, p < 0.001), and economic level (t = -2.45, p = 0.016). The most common diseases among the subjects were hypertension, hyperlipidemia, joint diseases and diabetes mellitus. Social networks (β = 0.46, p < 0.001) and wisdom (β = 0.55, p < 0.001) had partial mediating effects (z = 4.15, p < 0.001; z = 5.11, p < 0.001) on the relationship between subjects' lifestyle habits and healthy aging.

CONCLUSIONS

To increase the degree of healthy aging of subjects, it is necessary to establish a mediating intervention program that manages to have good lifestyle habits in daily life, increase social networks, and become wise.

Effects of Uncertainty, Appraisal of Uncertainty, and Self-Efficacy on the Quality of Life of Elderly Patients with Lung Cancer Receiving Chemotherapy: Based on Mishel's Theory of Uncertainty

Background and Objectives: The purpose of this study is to enhance the quality of life in elderly patients with lung cancer by understanding relations of uncertainty, appraisal of uncertainty, self-efficacy, and quality of life targeting elderly patients with lung cancer receiving anticancer therapy, and also analyzing the factors affecting the quality of life based on Mishel's theory. Materials and Methods: The subjects were a total of 112 lung cancer patients aged 65 or older receiving anticancer therapy. The data was collected by using self-report questionnaires targeting patients in hemato-oncology at Chungbuk National University Hospital. The data were analyzed using descriptive statistics, a t-test, an analysis of variance, Pearson's correlational coefficients, and hierarchical regression analysis. Results: In stage 1, anticancer therapy (chemotherapy) (β = -0.34, p < 0.001), economic condition (low) (β = -0.30, p < 0.001), the number of anticancer therapies (three times or more) (β = -0.29, p < 0.001), and education (graduation from high school or higher) (β = 0.18, p = 0.033) were influencing factors (F = 0.52, p < 0.001). In stage 2, self-efficacy (β = 0.41, p < 0.001), appraisal of uncertainty: danger (β = -0.29, p < 0.001), appraisal of uncertainty: opportunity (β = 0.18, p = 0.018), the number of anticancer therapies (three times or more) (β = -0.17, p = 0.006), and anticancer therapy (chemotherapy) (β = -0.14, p = 0.031) were influencing factors, which showed 74.2% explanatory power (F = 26.17, p < 0.001). Conclusions: In order to improve the quality of life of subjects, it would be necessary to develop interventions for raising their self-efficacy by considering their degree of education, economic condition, the types and numbers of anticancer therapies, and understanding of the appraisal of uncertainty about the disease is assessed as an opportunity factor or a danger factor.

Toxicity and Biodistribution of Fragmented Polypropylene Microplastics in ICR Mice

Currently, polypropylene (PP) is used in various products, thus leading to high daily exposure in humans. Thus, it is necessary to evaluate the toxicological effects, biodistribution, and accumulation of PP microplastics in the human body. In this study, administration of two particle sizes of PP microplastics (approximately 5 and 10-50 µm) did not lead to any significant changes in several toxicological evaluation parameters, including body weight and pathological examination, compared with the control group in ICR mice. Therefore, the approximate lethal dose and no-observed-adverse-effect level of PP microplastics in ICR mice were established as ≥2000 mg/kg. Furthermore, we manufactured cyanine 5.5 carboxylic acid (Cy5.5-COOH)-labeled fragmented PP microplastics to monitor real-time in vivo biodistribution. After oral administration of the Cy5.5-COOH-labeled microplastics to the mice, most of the PP microplastics were detected in the gastrointestinal tract and observed to be out of the body after 24 h in IVIS Spectrum CT. Therefore, this study provides a new insight into the short-term toxicity, distribution, and accumulation of PP microplastics in mammals.

Effects of General Characteristics, Emotional Labor, Empathy Ability, and Wisdom on the Psychological Well-Being of Female Caregivers Visiting the Homes of Vulnerable Care Recipients and the Elderly

The purpose of this study is to analyze how general characteristics, emotional labor, empathy ability, and wisdom affect the psychological well-being of female caregivers. The research design is a descriptive correlational study. Data were collected using a self-report questionnaire, and analyzed using the SPSS Windows 27.0 program for hierarchical regression analysis. The results showed that there were differences in psychological well-being according to the work experience, education, and monthly income of 129 participants. In the analysis of the factors affecting the participants' psychological well-being, model 1 showed 18.9% explanatory power with educational experience (ß = -0.23, p = 0.012) and monthly income (ß = 0.25, p = 0.007). In model 2, educational experience (ß = -0.23, p = 0.004), monthly income (ß = 0.20, p = 0.017), and emotional labor (ß = -0.41, p < 0.001) were the affecting factors, and the explanatory power increased by 16.1%, showing 35.0% overall. In model 3, educational experience (ß =-0.28, p < 0.001), emotional labor (ß = -0.35, p < 0.001), empathy ability (ß = 0.23, p = 0.001), and wisdom (ß = 0.52, p < 0.001) were the affecting factors, and the explanatory power increased by 36.9%, showing 71.9% overall. To enhance the psychological well-being of the participants, the head of the caregiving center should consider the education and income of caregivers. The center should also operate programs and prepare policies to reduce emotional labor and enhance empathy ability and wisdom.

Plasma Surface Modification of 3Y-TZP at Low and Atmospheric Pressures with Different Treatment Times

The efficiency of plasma surface modifications depends on the operating conditions. This study investigated the effect of chamber pressure and plasma exposure time on the surface properties of 3Y-TZP with N2/Ar gas. Plate-shaped zirconia specimens were randomly divided into two categories: vacuum plasma and atmospheric plasma. Each group was subdivided into five subgroups according to the treatment time: 1, 5, 10, 15, and 20 min. Following the plasma treatments, we characterized the surface properties, including wettability, chemical composition, crystal structure, surface morphology, and zeta potential. These were analyzed through various techniques, such as contact angle measurement, XPS, XRD, SEM, FIB, CLSM, and electrokinetic measurements. The atmospheric plasma treatments increased zirconia's electron donation (γ-) capacity, while the vacuum plasma treatments decreased γ- parameter with increasing times. The highest concentration of the basic hydroxyl OH(b) groups was identified after a 5 min exposure to atmospheric plasmas. With longer exposure times, the vacuum plasmas induce electrical damage. Both plasma systems increased the zeta potential of 3Y-TZP, showing positive values in a vacuum. In the atmosphere, the zeta potential rapidly increased after 1 min. Atmospheric plasma treatments would be beneficial for the adsorption of oxygen and nitrogen from ambient air and the generation of various active species on the zirconia surface.

Nonsteroidal Anti-Inflammatory Drug Conjugated with Gadolinium (III) Complex as an Anti-Inflammatory MRI Agent

Studies have been actively conducted to ensure that gadolinium-based contrast agents for magnetic resonance imaging (MRI) are accompanied by various biological functions. A new example is the anti-inflammatory theragnostic MRI agent to target inflammatory mediators for imaging diagnosis and to treat inflammatory diseases simultaneously. We designed, synthesized, and characterized a Gd complex of 1,4,7-tris(carboxymethylaza) cyclododecane-10-azaacetylamide (DO3A) conjugated with a nonsteroidal anti-inflammatory drug (NSAID) that exerts the innate therapeutic effect of NSAIDs and is also applicable in MRI diagnostics. Gd-DO3A-fen (0.1 mmol/kg) was intravenously injected into the turpentine oil-induced mouse model, with Gd-DO3A-BT as a control group. In the in vivo MRI experiment, the contrast-to-noise ratio (CNR) was higher and persisted longer than that with Gd-DO3A-BT; specifically, the CNR difference was almost five times at 2 h after injection. Gd-DO3A-fen had a binding affinity (K_a) of 6.68 × 10⁶ M^-1 for the COX-2 enzyme, which was 2.1-fold higher than that of fenbufen, the original NSAID. In vivo evaluation of anti-inflammatory activity was performed in two animal models. In the turpentine oil-induced model, the mRNA expression levels of inflammatory parameters such as COX-2, TNF-α, IL-1β, and IL-6 were reduced, and in the carrageenan-induced edema model, swelling was suppressed by 72% and there was a 2.88-fold inhibition compared with the saline group. Correlation analysis between in vitro, in silico, and in vivo studies revealed that Gd-DO3A-fen acts as an anti-inflammatory theragnostic agent by directly binding to COX-2.

Factors Influencing Performance of Exercise Behavior of Middle-Aged Men with Chronic Disease Based on the Information-Motivation-Behavioral Skill-Revealed-Related Variables (IMBR) Model

The purpose of this study was to analyze the factors influencing performance of exercise behavior of middle-aged men with chronic disease by adding variables through literature to the Information-Motivation-Behavioral skill model. Subjects of this study are total 171 people belonging to exercise clubs. In the results of putting the control variable in the step-1 of the hierarchical regression analysis, the health condition, smoking, the number of exercises per week, and hours of each exercise were revealed as influence factors and showed 38.4% explanatory power on the performance of exercise behavior. In the results of putting the factors required for behavioral change in the step-2 analysis, the information for exercise, motivation for exercise, sport commitment, and perceived barriers to exercise were influence factors, showing 60.1% explanatory power on the performance of exercise behavior. In the results of putting the exercise self-efficacy of exercise behavioral skills in the step-3 analysis, it was revealed as an influence factor that showed 63.0% explanatory power. Regarding the influence on participants' exercise behavior, the factors required for behavioral change and behavioral skill factors were relatively more important than the general characteristics. This study suggests application of IMBR model to the program for exercise behavior.

Flavonoid-Conjugated Gadolinium Complexes as Anti-Inflammatory Theranostic Agents

In this study, we designed, synthesized, and evaluated gadolinium compounds conjugated with flavonoids as potential theranostic agents for the treatment of inflammation. These novel theranostic agents combine a molecular imaging agent and one of three flavonoids (galangin, chrysin, and 7-hydroxyflavone) as anti-inflammatory drugs as a single integrated platform. Using these agents, MR imaging showed contrast enhancement (>10 in CNR) at inflamed sites in an animal inflammation model, and subsequent MR imaging used to monitor the therapeutic efficacy of these integrated agents revealed changes in inflamed regions. The anti-inflammatory effects of these agents were demonstrated both in vitro and in vivo. Furthermore, the antioxidant efficacy of the agents was evaluated by measuring their reactive oxygen species scavenging properties. For example, Gd-galangin at 30 μM showed a three-fold higher ROS scavenging of DPPH. Taken together, our findings provide convincing evidence to indicate that flavonoid-conjugated gadolinium compounds can be used as potentially efficient theranostic agents for the treatment of inflammation.

Systemic proinflammatory-profibrotic response in aortic stenosis patients with diabetes and its relationship with myocardial remodeling and clinical outcome

Background

It is unclear whether and how diabetes mellitus may aggravate myocardial fibrosis and remodeling in the pressure-overloaded heart. We investigated the impact of diabetes on the prognosis of aortic stenosis (AS) patients and its underlying mechanisms using comprehensive noninvasive imaging studies and plasma proteomics.

Methods

Severe AS patients undergoing both echocardiography and cardiovascular magnetic resonance (CMR) (n=253 of which 66 had diabetes) comprised the imaging cohort. The degree of replacement and diffuse interstitial fibrosis by late gadolinium enhancement (LGE) and extracellular volume fraction (ECV) was quantified using CMR. Plasma samples were analyzed with the multiplex proximity extension assay for 92 proteomic biomarkers in a separate biomarker cohort of severe AS patients (n=100 of which 27 had diabetes).

Results

In the imaging cohort, diabetic patients were older (70.4±6.8 vs. 66.7±10.1 years) and had a higher prevalence of ischemic heart disease (28.8% vs. 9.1%), with more advanced ventricular diastolic dysfunction. On CMR, diabetic patients had increased replacement and diffuse interstitial fibrosis (LGE% 0.3 [0.0–1.6] versus 0.0 [0.0–0.5], p=0.009; ECV% 27.9 [25.7–30.1] versus 26.7 [24.9–28.5], p=0.025) (Figure 1).

Plasma proteomics analysis of the biomarker cohort revealed that 9 proteins (E-selectin, interleukin-1 receptor type 1, interleukin-1 receptor type 2, galectin-4, intercellular adhesion molecule 2, integrin beta-2, galectin-3, growth differentiation factor 15, and cathepsin D) are significantly elevated in diabetic AS patients (Figure 2). Pathway over-representation analyses of the plasma proteomics with Gene Ontology terms indicated that pathways related to inflammatory response and extracellular matrix components were enriched, suggesting that diabetes is associated with systemic effects that evoke proinflammatory and profibrotic response to the pressure-overloaded myocardium.

During follow-up (median 6.3 years [IQR 5.2–7.2]) of the imaging cohort, 232 patients received aortic valve replacement (AVR) with 53 unexpected heart failure admissions or death. Diabetes was a significant predictor of heart failure and death, independent of clinical covariates and AVR (hazard ratio 1.88, 95% confidence interval 1.06–3.31, p=0.030).

Conclusion

Plasma proteomic analyses indicate that diabetes potentiates the systemic proinflammatory and profibrotic milieu in AS patients. These systemic biological changes underlie the increase of myocardial fibrosis, diastolic dysfunction, and worse clinical outcomes in severe AS patients with concomitant diabetes.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): National Research Foundation of Korea

Integrating wearables and modelling for monitoring rehabilitation following total knee joint replacement

BACKGROUND AND OBJECTIVE

Wearable inertial devices integrated with modelling and cloud computing have been widely adopted in the sports sector, however, their use in the health and medical field has yet to be fully realised. To date, there have been no reported studies concerning the use of wearables as a surrogate tool to monitor knee joint loading during recovery following a total knee joint replacement. The objective of this study is to firstly evaluate if peak tibial acceleration from wearables during gait is a good surrogate metric for computer modelling predicted functional knee loading; and secondly evaluate if traditional clinical patient related outcomes measures are consistent with wearable predictions.

METHODS

Following ethical approval, four healthy participants were used to establish the relationship between computer modelling predicted knee joint loading and wearable measured tibial acceleration. Following this, ten patients who had total knee joint replacements were then followed during their 6-week rehabilitation. Gait analysis, wearable acceleration, computer models of knee joint loading, and patient related outcomes measures including the Oxford knee score and range of motion were recorded.

RESULTS

A linear correlation (R² of 0.7-0.97) was observed between peak tibial acceleration (from wearables) and musculoskeletal model predicted knee joint loading during gait in healthy participants first. Whilst patient related outcome measures (Oxford knee score and patient range of motion) were observed to improve consistently during rehabilitation, this was not consistent with all patient's tibial acceleration. Only those patients that exhibited increasing peak tibial acceleration over 6-weeks rehabilitation were positively correlated with the Oxford knee score (R² of 0.51 to 0.97). Wearable predicted tibial acceleration revealed three patients with a consistent knee loading, five patients with improving knee loading, and two patients with declining knee loading during recovery. Hence, 20% of patients did not present with satisfactory joint loading following total knee joint replacement and this was not detected with current patient related outcome measures.

CONCLUSIONS

The use of inertial measurement units or wearables in this study provided additional insight into patients who were not exhibiting functional improvements in joint loading, and offers clinicians an 'off-site' early warning metric to identify potential complications during recovery and provide the opportunity for early intervention. This study has important implications for improving patient outcomes, equity, and for those who live in rural regions.

The Mediating Effect of Self-Efficacy and Coping Strategy in Relation to Job Stress and Psychological Well-Being of Home-Visiting Care Workers for Elderly during the COVID-19 Pandemic

The purpose of this study was to analyze the mediating effect of self-efficacy and coping strategy in the relationship between job stress and the psychological well-being of care workers. The subjects were 112 home-visiting care workers, and data were collected at four home-visiting nursing centers in a metropolitan city and a small and medium-sized city from July to August 2022. The collected data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation co-efficient, multiple linear regression, and Sobel test. The mean score of psychological well-being was 3.33 ± 0.46 out of a possible 5. The subject's psychological well-being was correlated with self-efficacy (r = 0.64, p < 0.001), problem-solving-focused coping (r = 0.58, p < 0.001), social-support-seeking coping (r = 0.34, p < 0.001), job stress (r = -0.31, p = 0.001), avoidance-focused coping (r = -0.37, p < 0.001). Self-efficacy (Z = -4.92, p < 0.001), problem-solving-focused coping (Z = -2.56, p = 0.010), and avoidance-focused coping (Z = -3.07, p = 0.002) had a mediating effect in the relationship between job stress and psychological well-being of the subjects during the COVID-19 pandemic. Based on these results, the psychological well-being nursing intervention program for home-visiting care workers need to include job stress, problem-solving-focused coping, and avoidance-focused coping.

Selective removal of radioactive iodine from water using reusable Fe@Pt adsorbents

Environmental damage from serious nuclear accidents should be urgently restored, which needs the removal of radioactive species. Radioactive iodine isotopes are particularly problematic for human health because they are released in large amounts and retain radioactivity for a substantial time. Herein, we prepare platinum-coated iron nanoparticles (Fe@Pt) as a highly selective and reusable adsorbent for iodine species, i.e., iodide (I^-), iodine (I₂), and methyl iodide (CH₃I). Fe@Pt selectively separates iodine species from seawater and groundwater with a removal efficiency ≥ 99.8%. The maximum adsorption capacity for the iodine atom of all three iodine species was determined to be 25 mg/g. The magnetic properties of Fe@Pt allow for the facile recovery and reuse of Fe@Pt, which remains stable with high efficiency (97.5%) over 100 uses without structural and functional degradation in liquid media. Practical application to the removal of radioactive ¹²⁹I and feasibility for scale-up using a 20 L system demonstrate that Fe@Pt can function as a reusable adsorbent for the selective removal of iodine species. This systematic procedure is a standard protocol for designing highly active adsorbents for the clean separation and removal of various chemical species dissolved in wastewater.

In the COVID-19 Era, Effects of Job Stress, Coping Strategies, Meaning in Life and Resilience on Psychological Well-Being of Women Workers in the Service Sector

The purpose of this study is to analyze the factors affecting the psychological well-being by using variables of job stress, coping strategies, meaning of life, and resilience to improve the quality of working life during COVID-19. The subjects were 135 adult women working for banks. Data were collected by having the subjects fill out a paper-and-pencil questionnaire, and analyzed through t-test, ANOVA, Pearson’s correlation coefficients, and multiple regression analysis. The subjects’ psychological well-being showed positive correlations with the social support-seeking coping mechanism (r = 0.33, p < 0.001), problem-solving-focused coping mechanism (r = 0.55, p < 0.001), meaning in life (r = 0.45, p < 0.001), and resilience (r = 0.37, p < 0.001). Psychological well-being showed negative correlations with job stress (r = −0.44, p < 0.001) and avoidance-focused coping mechanism (r = −0.28, p = 0.001). The factors affecting the psychological well-being were problem-solving-focused coping mechanism (β = 0.35, p < 0.001), job role stress (β = −0.24, p < 0.001), meaning inlife (β = 0.29, p < 0.001), avoidance-focused coping mechanism (β = −0.23, p < 0.001), and resilience (β = 0.15, p = 0.023). It is necessary to formalize psychological intervention to induce the improvement of the quality of work life by increasing the psychological well-being of working women during the COVID-19 pandemic. It is suggested that intervention is made in consideration of variables identified as influencing factors to increase the psychological well-being of women workers.

Thermodynamic Studies on the Hydrolysis of Trivalent Plutonium and Solubility of Pu(OH)3(am)

The temperature-dependent reaction properties of actinide elements are of particular interest in the safety assessment of high-level radioactive waste (HLRW) disposal systems. In this study, the hydrolysis of Pu(III) and the solubility of Pu(OH)₃(am) were investigated at various temperatures (10-40 °C) in 0.1 M NaClO₄. A strong reducing condition for maintaining the oxidation state of Pu(III) while slowly increasing the pH of the solution was realized by electrolysis. The formation constants of the first hydrolysis species, log ^*β₁^', and the solubility products of Pu(OH)₃(am), log ^*K_s,0^', at 10, 17, and 40 °C were experimentally determined using spectrophotometry, laser-induced breakdown detection, and radiometry. The enthalpy and entropy changes for these reactions were estimated using the van't Hoff equation. The first hydrolysis of Pu(III) is endothermic (Δ_rH_m^° = 34.10 ± 4.48 kJ mol^-1), and the dissolution of Pu(OH)₃(am) is exothermic (Δ_rH_m^° = -294.29 ± 23.05 kJ mol^-1) with negative entropy changes. These thermodynamic data will contribute to improving the reliability of the safety assessment of HLRW disposal facilities and understanding the geochemical behavior of Pu under reducing or anoxic aqueous conditions at elevated temperatures.

Effects of Health Status, Depression, Gerotranscendence, Self-Efficacy, and Social Support on Healthy Aging in the Older Adults with Chronic Diseases

Purpose of this study is to analyze factors affecting the healthy aging of the elderly with chronic diseases living in the community according to the worldwide aging phenomenon in line with the WHO’s healthy aging strategy. The subjects were 116 elderly aged 65 years or up with one or more chronic diseases and residing in four cities. The collected data were analyzed by using the descriptive statistics, t-test, ANOVA, Pearson’s correlational coefficients, and stepwise multiple regression. The healthy aging of subjects showed positive correlations with the health status (r = 0.68, p < 0.001), gerotranscendence (r = 0.64, p < 0.001), self-efficacy (r = 0.65, p < 0.001), and social support (r = 0.47, p < 0.001), while the healthy aging and depression (r = −0.58, p < 0.001) showed a negative correlation. The factors affecting the healthy aging were health status (β = 0.24, p = 0.004), self-efficacy (β = 0.28, p < 0.001), education (β = −0.11, p = 0.057), exercise (β = 0.17, p = 0.003), gerotranscendence (β = 0.22, p = 0.004), and depression (β = −0.19, p = 0.009), and the explanatory power of those variables was 68.2%. Thus, it would be necessary to provide an intervention for the elderly that could habituate health-related education and exercise, maintain good health status, lower depression, aid control of themselves through the gerotranscendence, and increase self-efficacy.

Effect of Structural Fine-Tuning on Chelate Stability and Liver Uptake of Anionic MRI Contrast Agents

The purpose of this study is to assess the physicochemical properties and MRI diagnostic efficacy of two newly synthesized 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)-type Gd chelates, Gd-SucL and Gd-GluL, with an asymmetric α-substituted pendant arm as potential hepatocyte-specific magnetic resonance imaging contrast agents (MRI CAs). Our findings show that fine conformational changes in the chelating arm affect the in vivo pharmacokinetic behavior of the MRI CA, and that a six-membered chelating substituent of Gd-SucL is more advantageous in this system to avoid unwanted interactions with endogenous species. Gd-SucL exhibited a general DOTA-like chelate stability trend, indicating that all chelating arms retain coordination bonding. Finally, the in vivo diagnostic efficacy of highly stable Gd-SucL as a potential hepatocyte-specific MRI CA was evaluated using T₁-weighted MR imaging on an orthotopic hepatocarcinoma model.

Assessment of Various Density Functional Theory Methods for Finding Accurate Structures of Actinide Complexes

Density functional theory (DFT) is a widely used computational method for predicting the physical and chemical properties of metals and organometals. As the number of electrons and orbitals in an atom increases, DFT calculations for actinide complexes become more demanding due to increased complexity. Moreover, reasonable levels of theory for calculating the structures of actinide complexes are not extensively studied. In this study, 38 calculations, based on various combinations, were performed on molecules containing two representative actinides to determine the optimal combination for predicting the geometries of actinide complexes. Among the 38 calculations, four optimal combinations were identified and compared with experimental data. The optimal combinations were applied to a more complicated and practical actinide compound, the uranyl complex (UO₂(2,2′-(1E,1′E)-(2,2-dimethylpropane-1,3-dyl)bis(azanylylidene)(CH₃OH)), for further confirmation. The corresponding optimal calculation combination provides a reasonable level of theory for accurately optimizing the structure of actinide complexes using DFT.

Structural and spectroscopic studies of spontaneously formed crystalline Eu(iii)–aliphatic dicarboxylates at room temperature

Complexation of actinides and lanthanides with carboxylic organic ligands is a critical issue affecting radionuclide migration from deep geological disposal systems of spent nuclear fuel. A series of Eu(iii)–aliphatic dicarboxylate compounds, as chemical analogs of radioactive Am(iii) species, Eu₂(Ox)₃(H₂O)₆, Eu₂(Mal)₃(H₂O)₆, and Eu₂(Suc)₃(H₂O)₂, were synthesized and characterized using X-ray crystallography and time-resolved laser fluorescence spectroscopy to examine the ligand-dependent binding modes and the corresponding changes in spectroscopic properties. Powder X-ray crystallography results confirmed that all of the compounds presented a crystalline polymer structure with a trigonal prism square-face tricapped polyhedron geometry centered on Eu(iii) in a nine-coordinate environment involving nine oxygen atoms. This study captures the transition of the coordination modes of aliphatic dicarboxylate ligands from side-on to end-on binding as the carbon chain length increases. This transition is illustrated in malonate bindings involving a combination of side-on and end-on modes. Strongly enhanced luminescence, especially for the hypersensitive peak, indicates a low site symmetry in the formation of solid compounds. The number of remaining bound water molecules was estimated from the resultant increased luminescence lifetimes, which were in good agreement with crystal structures. The excitation–emission matrix spectra of these crystalline polymers suggest that Ox ligands promote the sensitized luminescence of Eu(iii), especially in the UV region. In the case of Mal and Suc ligands, charge transfer occurs in the opposite direction from Eu(iii) to the ligands under UV excitation, resulting in weaker luminescence.

This study captures the transition of the coordination modes of aliphatic dicarboxylate ligands from side-on to end-on binding, which is illustrated in malonate bindings involving a combination of side-on and end-on modes.

491 Comparison of Pandemic and Pre-pandemic Practices of Managing Acute Appendicitis

Aim

Acute appendicitis (AA) is a common indication for abdominal surgery, with more than 30,000 appendicectomies performed in England per year. However, SARS-CoV-2 (COVID-19) changed usual surgical practices following advice to minimise laparoscopic surgery, and instead favouring conservative management, or open surgery for AA.

Method

In this study, we compared the management of 50 patients with suspected/confirmed AA during the first wave of the COVID-19 pandemic at a district general hospital (DGH) with our usual practices, against 50 patients admitted with suspected/confirmed AA during a similar time period, one year prior to the pandemic.

Results

Demographics of patients in both groups were comparable with median age of 34 in the pandemic vs 32.5 in the pre-pandemic group. 74% of patients in the pandemic group (PG) underwent imaging to confirm appendicitis, compared to 58% of patients in the pre-pandemic group (PPG). 64% of PG patients were treated conservatively, compared to 8% in PPG patients. Outcomes demonstrated re-attendance events of 12% in the PG, as compared to 10% in the PPG, although the follow up period was longer in the PPG. Despite a significantly smaller number of patients managed surgically during the pandemic, 27% of patients undergoing appendicectomies had post-operative complications in the PG, as compared to 7% in the PPG.

Conclusions

During the pandemic, more patients at our DGH with AA were treated conservatively, more patients had re-attendance events and post-operative complications when compared to patients in the pre-pandemic group.

P–627 Optimal timing of day 6 blastocyst transfer in artificially prepared frozen-thawed embryo transfer cycles

Study question

When is the optimal timing of day 6 (D6) blastocyst transfer between the 6thday (P6)and the 7th(P7) day of progesterone administration in artificially prepared frozen-thawed embryo transfer(FET) cycle

Summary answer

When transferring D6 blastocysts in artificially prepared FET cycles, live birth rate tended to be higher in P6 group than in P7 group.

What is known already

Blastocyst transfer in FET cycles has increased due to several reasons including convenience for optimization of endometrial synchronization, improvement of laboratory techniques and preimplantation genetic testing. Meanwhile, D6 blastocyst which cryopreserved on day 6 after being developed to the full blastocyst stage, presented lower pregnancy outcomes in FET cycle than D5 blastocysts. However, there have been few studies on the optimal duration of progesterone administration when transferring D6 blastocysts.

Study design, size, duration

This was a retrospective cohort study including patients who underwent frozen-thawed blastocyst transfer in artificially prepared cycles from January 2000 to May 2020. Patients with D6 blastocyst transfer on the 6th day of progesterone administration were included in D6-P6 group, and patients with D6 blastocyst transfer on the 7th day of progesterone administration were included in D6-P7 group.

Participants/materials, setting, methods

Increasing dose of estradiol valerate was administered from the 3rd day of menstruation: 4 mg/day for the first four days, 6 mg/day for next four days, and then 8 mg/day until the confirmation of pregnancy. Progesterone was administered from the 14th day of menstruation if the endometrial thickness reached ≥7 mm. The independent t-test or Mann-Whitney test, chi-square test, and logistic regression analysis were performed.

Main results and the role of chance

A total of 50 patients were included, and 13 patients underwent FET on P6 and 37 patients underwent FET on P7. Live birth rate was comparable between the P6 group and the P7 group (18.9% vs. 15.4%, p = 0.775). Live birth rate was higher in the D6-P6 group than in the D6-P7 group after adjusting for age, AMH, endometrial thickness on the starting day of progesterone administration and good embryo rate transferred with statistical significance (OR: 6.716, p = 0.005).

Limitations, reasons for caution

Limitations of the present study is the retrospective design and the small sample size. Caution is needed in extrapolating results of this study because only intramural and vaginal progesterone supplementations were included in this study.

Wider implications of the findings: Even if the duration of blastocyst formation was delayed, frozen-thawed D6 blastocyst may need to be considered for on P6 rather than P7. The difference of live birth rate is not statistically significant. This study should be acknowledged for the underestimation of the difference because of the small sample size.

Trial registration number

Not applicable

Study of Aqueous Am(III)-Aliphatic Dicarboxylate Complexes: Coordination Mode-Dependent Optical Property and Stability Changes

The thermodynamics of Am(III) complex formation in natural groundwater systems is one of the major topics of research in the field of high-level radioactive waste management. In this study, we investigate the absorption and luminescence properties of aqueous Am(III) complexes with a series of aliphatic dicarboxylates in order to learn the thermodynamic complexation behaviors in relation to binding geometries. The formation of Am(III) complexes with these carboxylate ligands induced distinct red shifts in the absorption spectra, which enabled chemical speciation. The formation constants determined by deconvolution of the absorption spectra showed a linear decrease for the three ligands (oxalate (Ox), malonate (Mal), and succinate (Suc)) and a mild decrease for the remaining ligands (glutarate (Glu) and adipate (Adi)). Time-resolved laser fluorescence spectroscopy (TRLFS) was used to obtain information about the aqua ligand, which indirectly indicated the bidentate bindings of these dicarboxylate ligands. A complementary attenuated total reflectance Fourier transform infrared (ATR-FTIR) study on Eu(III), which is a nonradioactive analogue of Am(III) ion, showed that the coordination modes differ depending on the alkyl chain length. Ox and Mal bind to Am(III) via side-on bidentate bindings with two carboxylate groups, resulting in the formation of stable 5- and 6-membered ring structures, respectively. On the other hand, Suc, Glu, and Adi form end-on bidentate bindings with a single carboxylate group, resulting in a 4-membered ring structure. Density functional theory calculations provided details about the bonding properties and supported the experimentally proposed coordination geometries. This study demonstrates that coordination mode-dependent changes in optical properties occur along with thermodynamic stability changes in Am(III)-dicarboxylate complexes.

Studies of aqueous U(iv) equilibrium and nanoparticle formation kinetics using spectrophotometric reaction modeling analysis

Hydrolysis of tetravalent uranium (U(iv)) and U(iv)-nanoparticle formation kinetics were examined over a wide range of temperatures using spectrophotometric reaction modeling analysis. The characteristic absorption bands representing U⁴⁺, U(OH)³⁺, and a proposed oxohydroxo species were newly identified in the UV region (190–300 nm). Dynamic absorption band changes in the UV and visible regions (360–800 nm) were explored to reevaluate the binary ion interaction coefficients for U(iv) ions and the thermodynamic constants of the primary hydrolysis reaction, including complexation constants, enthalpy, and entropy. No further hydrolysis equilibrium beyond the formation of U(OH)³⁺ was identified. Instead, an irreversible transformation of U(iv) ions to U(iv)-nanoparticles (NPs) was found to occur exclusively via the formation of a new intermediate species possessing characteristic absorption bands. The kinetic analysis, based on a two-step, pseudo-first-order reaction model, revealed that the rate of the initial step producing the intermediates is highly temperature-dependent with the measured kinetic energy barrier of ∼188 kJ mol⁻¹. With additional experimental evidence, we conclude that the intermediates are oligomeric oxohydroxo U(iv) species occurring from the condensation of U(iv) ions and simultaneously participating in the nucleation and growth process of UO₂(cr)-NPs.

The primary hydrolysis equilibrium of U⁴⁺ and the kinetics of U(iv)-nanoparticle formation were investigated by using spectrophotometric reaction modeling analysis and the spectral data collected in the UV and visible regions.

Antimicrobial susceptibility of Staphylococcus species isolated from prosthetic joints with a focus on fluoroquinolone-resistance mechanisms

We investigated susceptibility to antimicrobials of 89 staphylococcal species from PJIs and analyzed fluoroquinolone (FQ)-resistance mechanisms. Staphylococcal isolates showed high resistance to oral antimicrobials, with the exception of TMP-STX and linezolid. The main mechanism of resistance to FQ was mutations in quinolone-resistance-determining-regions. Fifteen percent of Staphylococcus aureus overexpressed efflux-pump genes.

Vitiligo-like depigmentation after pembrolizumab treatment in patients with non-small cell lung cancer: a case report

Immune checkpoint inhibitors (ICIs) targeting programmed death-1 (PD-1) pathway have significantly improved outcomes for patients with a variety of malignancies, including non-small cell lung cancer (NSCLC). In contrast, the incidence of immune-related cutaneous adverse events such as vitiligo have been on the rise because of the increasing use of ICIs. Vitiligo-like depigmentation has been reported in only 2.0% to 8.3% of patients with melanoma and is considered a favorable prognostic factor. However, it has been rarely reported in patients with non-melanoma malignancies. We describe a case of vitiligo-like skin depigmentation after pembrolizumab use in a patient with stage IV NSCLC. Multiple ill-defined painless and non-pruritic depigmented patches appeared on the patient’s hands, scrotum, and lower lip after five months of pembrolizumab. We continued treatment with pembrolizumab 2 mg/kg for 14 months with close monitoring of vitiligo lesions until the progression of brain metastasis, but the vitiligo-like depigmentation did not improve by the combined excimer laser and topical corticosteroid therapy. Clinicians should be aware that immune-related cutaneous adverse events such as vitiligo-like depigmentation are not limited to cases of melanoma but arise as a direct result of anti-PD-1 therapy.

An international collaborative evaluation of central serous chorioretinopathy: different therapeutic approaches and review of literature. The European Vitreoretinal Society central serous chorioretinopathy study

PURPOSE

To study and compare the efficacy of different therapeutic options for the treatment of central serous chorioretinopathy (CSCR).

METHODS

This is a nonrandomized, international multicentre study on 1719 patients (1861 eyes) diagnosed with CSCR, from 63 centres (24 countries). Reported data included different methods of treatment and both results of diagnostic examinations [fluorescein angiography and/or optical coherent tomography (OCT)] and best-corrected visual acuity (BCVA) before and after therapy. The duration of observation had a mean of 11 months but was extended in a minority of cases up to 7 years. The aim of this study is to evaluate the efficacy of the different therapeutic options of CSCR in terms of both visual (BCVA) and anatomic (OCT) improvement.

RESULTS

One thousand seven hundred nineteen patients (1861 eyes) diagnosed with CSCR were included. Treatments performed were nonsteroidal anti-inflammatory eye drops, laser photocoagulation, micropulse diode laser photocoagulation, photodynamic therapy (PDT; Standard PDT, Reduced-dose PDT, Reduced-fluence PDT), intravitreal (IVT) antivascular endothelial growth factor injection (VEGF), observation and other treatments. The list of the OTHERS included both combinations of the main proposed treatments or a variety of other treatments such as eplerenone, spironolactone, acetazolamide, beta-blockers, anti-anxiety drugs, aspirin, folic acid, methotrexate, statins, vitis vinifera extract medication and pars plana vitrectomy. The majority of the patients were men with a prevalence of 77%. The odds ratio (OR) showed a partial or complete resolution of fluid on OCT with any treatment as compared with observation. In univariate analysis, the anatomical result (improvement in subretinal fluid using OCT at 1 month) was favoured by age <60 years (p < 0.005), no previous observation (p < 0.0002), duration less than 3 months (p < 0.0001), absence of CSCR in the fellow eye (p = 0.04), leakage outside of the arcade (p = 0.05) and fluid height >500 μm (p = 0.03). The OR for obtaining partial or complete resolution showed that anti-VEGF and eyedrops were not statistically significant; whereas PDT (8.5), thermal laser (11.3) and micropulse laser (8.9) lead to better anatomical results with less variability. In univariate analysis, the functional result at 1 month was favoured by first episode (p = 0.04), height of subretinal fluid >500 μm (p < 0.0001) and short duration of observation (p = 0.02). Finally, there was no statistically significant difference among the treatments at 12 months.

CONCLUSION

Spontaneous resolution has been described in a high percentage of patients. Laser (micropulse and thermal) and PDT seem to lead to significant early anatomical improvement; however, there is little change beyond the first month of treatment. The real visual benefit needs further clarification.

Optical and Mechanical Properties of Highly Translucent Dental Zirconia

The aim was to evaluate the translucency, opalescence, and fluorescence of highly translucent zirconia, lithium disilicate, and bovine teeth. One mm-thick specimens of five monolithic zirconia systems, two glass-ceramics, and bovine enamel/dentin were investigated. A spectrophotometer (Ci7600) was used to measure the CIELab color coordinates, and the translucency and opalescence values were obtained. For evaluating the fluorescence emission, the differences in spectral reflectance by the UV component of illumination were calculated. The microstructures of ceramic specimens were examined with a scanning electron microscope and the chemical compositions were determined with an X-ray fluorescence spectrometer. Mechanical properties were appraised with three-point bending strength, indentation fracture toughness, and Vickers hardness. Data were analyzed using a one-way ANOVA, followed by Tukey’s multiple comparison test (α = 0.05). A higher yttria content (5 mol%) significantly improved the translucency of zirconia ceramics, while they were less translucent than lithium disilicate (p < 0.05). Lowering the alumina content below 0.05 wt.% enhanced the translucency (p < 0.05), but a small amount of alumina was still required to obtain full densification. 0.05 wt.% Fe was used to increase the chroma of zirconia specimens without compromising their mechanical properties. The Er-containing zirconia specimen showed a maximal fluorescence emission at 430 nm. The degree of opalescence was affected by the microstructures of ceramic materials. The microstructure, incorporation of a secondary phase, and sintering behavior can have a strong impact on the final mechanical and optical properties of dental ceramics. Addition of small amounts of metal oxides can affect the translucency, opalescence or fluorescence qualities of zirconia

Gadolinium-Based Neuroprognostic Magnetic Resonance Imaging Agents Suppress COX-2 for Prevention of Reperfusion Injury after Stroke

Advancements in recanalization therapies have rendered reperfusion injury an important challenge for stroke management. It is essential to work toward effective therapeutics that protect the ischemic brain from reperfusion injury. Here, we report a new concept of neuroprognostic agents, which combine molecular diagnostic imaging and targeted neuroprotection for treatment of reperfusion injury after stroke. These neuroprognostic agents are inflammation-targeted gadolinium compounds conjugated with nonsteroidal anti-inflammatory drugs (NSAIDs). Our results demonstrated that gadolinium-based MRI contrast agents conjugated with NSAIDs suppressed the increase in cyclooxygenase-2 (COX-2) levels, ameliorated glial activation, and neuron damage that are phenotypic for stroke by mitigating neuroinflammation, which prevented reperfusion injury. In addition, this study showed that the neuroprognostic agents are promising T₁ molecular MRI contrast agents for detecting precise reperfusion injury locations at the molecular level. Our results build on this new concept of neuroprognostics as a novel management strategy for ischemia-reperfusion injury, combining neuroprotection and molecular diagnostics.

P1274 Early surgery versus watchful waiting in patients with moderate aortic stenosis and left ventricular systolic dysfunction

Background

Aortic stenosis (AS) induces significant pressure overload to the left ventricle (LV) and its burden may increase if there is concomitant LV systolic dysfunction. Severe AS with LV systolic dysfunction is a class I indication for aortic valve replacement (AVR) irrespective of symptoms, however, this recommendation is not well established in those with moderate AS and LV systolic dysfunction. In this study, we sought to investigate the clinical impact of surgical AVR among patients with moderate AS and LV systolic dysfunction.

Methods

From 2001 to 2017, we retrospectively but consecutively identified patients with moderate AS and LV systolic dysfunction from a single tertiary hospital. Moderate AS was defined as aortic valve area between 1.0 and 1.5cm2 and LV systolic dysfunction as LV ejection fraction less than 50%. The primary outcome was all-cause death and we additionally analyzed cardiac death as a secondary endpoint. The outcomes were compared between those who underwent early surgical AVR at the stage of moderate AS versus those who were followed without AVR at the outpatient clinic.

Results

Among a total of 257 patients with moderate AS and concomitant LV systolic dysfunction (70.0 ± 11.3 years, 63.4% of male), 34 patients received early AVR. Patients in the AVR group was younger than the observation group (64.2 ± 8.1 vs. 70.9 ± 11.5, respectively), and had a lower prevalence of hypertension and chronic kidney disease. During a mean of 3-year follow up, 112 patients (47.5%) died and the overall death rate was 15.367 per 100 person-year (PY). The AVR group showed a significantly lower rate of all-cause death than the observation group (5.241PY vs. 18.160PY, p-value = 0.002). After multivariable Cox proportional hazard regression adjusting for age, sex, comorbidities and laboratory data, early AVR at the stage of moderate AS significantly reduced the risk of all-cause death (hazard ratio [HR] 0.340, 95% confidence interval [CI] 0.117 - 0.985, p-value = 0.047). However, there was no risk reduction of cardiac death (HR 0.578 95% CI 0.150 - 2.231, p-value = 0.426).

Conclusions

In patients with moderate AS and LV systolic dysfunction, AVR reduces the risk of all-cause death. A prospective design study is warranted to confirm our findings in the near future.

Abstract P1274 Figure. Kaplan-Meier curves for deaths

In vivo neutron capture therapy of cancer using ultrasmall gadolinium oxide nanoparticles with cancer-targeting ability

Gadolinium neutron capture therapy (GdNCT) is considered as a new promising cancer therapeutic technique. Nevertheless, limited GdNCT applications have been reported so far. In this study, surface-modified ultrasmall gadolinium oxide nanoparticles (UGNPs) with cancer-targeting ability (d_avg = 1.8 nm) were for the first time applied to the in vivo GdNCT of cancer using nude model mice with cancer, primarily because each nanoparticle can deliver hundreds of Gd to the cancer site. For applications, the UGNPs were grafted with polyacrylic acid (PAA) for biocompatibility and colloidal stability, which was then conjugated with cancer-targeting arginylglycylaspartic acid (RGD) (shortly, RGD-PAA-UGNPs). The solution sample was intravenously administered into the tails of nude model mice with cancer. At the time of the maximum accumulation of the RGD-PAA-UGNPs at the cancer site, which was monitored using magnetic resonance imaging, the thermal neutron beam was locally irradiated onto the cancer site and the cancer growth was monitored for 25 days. The cancer growth suppression was observed due to the GdNCT effects of the RGD-PAA-UGNPs, indicating that the surface-modified UGNPs with cancer-targeting ability are potential materials applicable to the in vivo GdNCT of cancer.

A cancer growth suppression was observed due to the GdNCT effects of the RGD-PAA-UGNPs.

P1603 Changes of cardiac function in cirrhotic patients after liver transplantation

Funding Acknowledgements

This study was supported by the grant of CJ healthcare 2016 research fund.

Background

Liver cirrhosis (LC) has been known to affect cardiovascular performance. Limited study have evaluated the alteration of myocardial function in patients with LC after liver transplantation (LT).

Purpose

The aim of study was to evaluate changes of cardiac function in patients with cirrhosis following LT using conventional and speckle-tracking echocardiography and late gadolinium enhancement (LGE) of cardiac magnetic resonance (MR).

Methods

Thirty-five patients with cirrhosis (mean age, 57.1 ± 9.0; male, 75%) who were listed for LT were prospectively enrolled. Patients underwent conventional, speckle-tracking echocardiography, and cardiac MR imaging with LGE. Echocardiography and cardiac MR were performed at pre and 1 year after LT. Cirrhotic patients were compared with normal control (n = 20, mean age, 65.0 ± 14.8; men, 11(55%)) and echocardiographic and cardiac MR data were compared pre and post LT.

Results

Conventional and speckle-tracking echocardiography and Cardiac MR imaging demonstrated hyperdynamic left ventricular (LV) function in patients with cirrhosis (LV ejection fraction (EF) with cardiac MR 67.8 ± 7.0% in LC vs. 63.4 ± 6.4% in control, P = 0.028; global longitudinal strain (GLS) -24.3 ± 2.6% in LC vs. -18.6 ± 2.2% in control, P &lt; 0.001). There were no LGE in patients with cirrhosis and no significant differences in LV size, LV wall thickness, LV mass index, and diastolic function between cirrhotic patients and control group (all P &gt; 0.1). Corrected QT interval (QTc) in electrocardiogram was prolonged in LC patients (P &lt; 0.001). One-year after LT, LV end-diastolic diameter and LV end-diastolic volume significantly decreased (P = 0.016 and 0.022, respectively). Although LVEF showed no significant changes 1 year post-LT (P = 0.362), LV-GLS (from -24.7 ± 1.8% to -20.8 ± 3.4%, P &lt; 0.001) significantly decreased. QTc interval also decreased 1 year after LT (from 470.4 ± 29.6msec to 428.2 ± 31.6msec, P = 0.001).

Conclusions

The present study demonstrated that cirrhotic patients showed hyperdynamic circulation and prolonged QTc interval compared with normal controls. After 1 year LT, LV size reduced and augmented LV function was normalized. Given that no LGE in cardiac MR and normalized GLS and QTc after LT, cardiac dysfunction in LC patients could be reversed by LT.

P1368 Effect of angiotensin receptor blocker in patients with moderate or severe aortic stenosis: a randomized controlled trial

Funding Acknowledgements

This study was supported by grants from Boryung Pharmacy Research Fund.

Background/Introduction: Pathophysiology of aortic stenosis (AS) and several previous studies suggested the potential role of angiotensin receptor blocker (ARB) in patients with AS.

Purpose

We aimed to investigate the effects of Fimasartan, an ARB, on exercise capacity and progression of AS in patients with moderate to severe AS.

Methods

We conducted a prospective, randomized, double-blind, placebo-controlled trial in 32 normotensive or controlled-hypertensive patients with moderate or severe AS. Study participants were randomized to Fimasartan 30 mg to 60 mg daily (n = 14) or placebo (n = 18) for 1 year, and underwent cardiopulmonary exercise test, 6-minute walk test, and echocardiography at 0, 6, and 12 months, with follow-up data available in 29 subjects.

Results

Significant reductions in blood pressures were observed in the Fimasartan group but not in the placebo group. Two of the 14 patients in the Fimasartan group withdrew the study due to mild symptoms probably related with the decreased blood pressure, and one patient decline the study protocol. After the 12-month treatment, the peak oxygen consumption (VO2; the primary outcome) in the Fimasartan group was significantly decreased (from 28.3 ± 5.9 to 25.4 ± 3.8 mL/min/kg, P = 0.021) but not in the placebo group (P for interaction = 0.046) (Figure 1A). The severity of AS showed a gradual progression in both groups, without inter-group differences (mean transaortic pressure; Fimasartan group, +4.0 ± 3.8 mmHg/year; placebo group, +5.3 ± 6.2 mmHg/year; P for interaction = 0.429) (Figure 1B). Parameters of left ventricular systolic and diastolic function did not change in both groups.

Conclusions

The use of ARB impaired exercise capacity in patients with moderate or severe AS, and did not prevent the progression of AS. However, due to the small number of participants, further studies are required to confirm these findings.

Abstract P1368 Figure.

Mitochondrial DNA content and oxidation in bipolar disorder and its role across brain regions

The underlying pathology of bipolar disorder remains unknown, though evidence is accumulating to support a role of mitochondrial dysfunction. In this study, we aim to investigate electron transport chain complex I subunit NDUFS7 protein expression; mtDNA content; common deletion; and oxidation in the Broadmann area 24 (BA24), cerebellum, hippocampus, and prefrontal cortex from patients with bipolar disorder, schizophrenia, and non-psychiatric controls. Here, we demonstrate no changes in NDUFS7 in BA24, cerebellum or hippocampus, increases in mtDNA content in hippocampus of patients with bipolar disorder, and decreases in mtDNA oxidation in patients with bipolar disorder and schizophrenia, respectively. Paired analysis between BA24 and cerebellum reveal increases within NDUFS7 levels and mtDNA content in cerebellum of patients with bipolar disorder or schizophrenia. We found a positive correlation between NDUFS7 and mtDNA content (ND4 and ND5) when combining brain regions. Our study supports the involvement of mitochondrial dysfunction in bipolar disorder and schizophrenia.

Complexation of UO2(CO3)34- with Mg2+ at varying temperatures and its effect on U(vi) speciation in groundwater and seawater

The ternary alkaline earth metal uranyl tricarbonate complexes, MnUO2(CO3)32n-4 (M = Mg and Ca), have been considered to be the major U(vi) species contributing to uranium mobility in natural water. Although MgUO2(CO3)32- can account for a substantial portion of U(vi) in a Mg2+-rich aqueous system and most processes regarding uranium are subjected to variable temperatures, chemical thermodynamic data for the prediction of the formation of MgUO2(CO3)32- at variable temperatures are still unknown. To fill the knowledge gap in the current chemical thermodynamic database, ultraviolet/visible (UV/Vis) absorption spectroscopy was employed to determine the formation constants (log K') of MgUO2(CO3)32- at varying temperatures of 10-85 °C in 0.5 mol kg-1 NaCl. The formation constants at infinite dilution, log K°, were obtained with specific ion interaction theory (SIT), and an increasing tendency of log K° with temperature was observed. Using calorimetric titration, the endothermic molar enthalpy of reaction (ΔrHm) of Mg2+ complexation with UO2(CO3)34- was determined at 25 °C. According to the chemical thermodynamic data obtained in this work, approximation models for the prediction of the temperature-dependent formation constant at a given temperature were examined and the constant enthalpy approximation with modification to the isoelectric reaction showed a satisfactory agreement with our experimental results. Finally, the effects of temperature on U(vi) speciation in Mg2+-rich groundwater and U(vi) extraction from seawater by amidoxime derivatives were examined. For the first time, this work provides important chemical thermodynamic data of MgUO2(CO3)32n-4 to assess the impact of temperature on U(vi) behaviour in groundwater and seawater.

Prevalence of fentanyl exposure and knowledge regarding the risk of its use among emergency department patients with active opioid use history at an urban medical center in Baltimore, Maryland

Background: Overdose deaths from fentanyl and its analogs have increased significantly since 2013. There are limited data regarding the prevalence of fentanyl exposure among emergency department (ED) patients with active opioid use.Methods: We conducted a cross-sectional study at an urban hospital from May 20 to July 30, 2018. A convenience sample of adult ED patients with active opioid use, defined as opioid use within seven days prior to ED visit, were enrolled. Rapid Response^® Single Drug Test Strip (BTNX Inc., Markham, Canada) was used to detect fentanyl in urine samples. Information on demographic, substance use history, and knowledge of fentanyl was obtained using a brief survey tool. Our primary outcome was the prevalence of fentanyl exposure; secondary outcomes included patients' knowledge regarding potency, risk of overdose death from fentanyl and intentional purchase of fentanyl.Results: During our study period, 451 patients reported active substance use. Of these, 208 reported active opioid use and 165 consented for the study. The median age was 49 years [interquartile range: 38, 57] and 77.0% (n = 127) were male; 42 participants (25.5%) presented to ED after an acute overdose event. Heroin was the preferred opioid of use in 90.8% of the participants, primarily via intranasal route (64.6%). Polysubstance use was reported in 98.8%, most commonly with cocaine (57.6%; n = 95). Fentanyl was detected in 104 out of 129 urine samples tested (80.6%). 84.2% (n = 139) identified fentanyl as highly potent and 85.5% (n = 141) recognized highest risk of death in fentanyl overdose. A larger proportion of non-overdose participants intentionally purchased fentanyl (34.1%; n = 42) compared to the overdose group (16.7%, n = 7; p = .04).Conclusions: The majority of ED patient with active opiate use were exposed to fentanyl while one in three participants intentionally purchased fentanyl despite their awareness of its potency and the high-risk of death from overdose.

Formation of CaUO2(CO3)32− and Ca2UO2(CO3)3(aq) complexes at variable temperatures (10–70 °C)

The ternary complexation of calcium uranyl tricarbonate species, CaUO₂(CO₃)₃²⁻ and Ca₂UO₂(CO₃)₃(aq), which are the predominant U(vi) complexes in groundwater and seawater, was investigated at variable temperatures from 10 to 70 °C.

Synthesis and Evaluation of Manganese(II)-Based Ethylenediaminetetraacetic Acid-Ethoxybenzyl Conjugate as a Highly Stable Hepatobiliary Magnetic Resonance Imaging Contrast Agent

In this study, we designed and synthesized a highly stable manganese (Mn²⁺)-based hepatobiliary complex by tethering an ethoxybenzyl (EOB) moiety with an ethylenediaminetetraacetic acid (EDTA) coordination cage as an alternative to the well-established hepatobiliary gadolinium (Gd³⁺) chelates and evaluated its usage as a T₁ hepatobiliary magnetic resonance imaging (MRI) contrast agent (CA). This new complex exhibits higher r₁ relaxivity (2.3 mM^-1 s^-1) than clinically approved Mn²⁺-based hepatobiliary complex Mn-DPDP (1.6 mM^-1 s^-1) at 1.5 T. Mn-EDTA-EOB shows much higher kinetic inertness than that of clinically approved Gd³⁺-based hepatobiliary MRI CAs, such as Gd-DTPA-EOB and Gd-BOPTA. In addition, in vivo biodistribution and MRI enhancement patterns of this new Mn²⁺ chelate are comparable to those of Gd³⁺-based hepatobiliary MRI CAs. The diagnostic efficacy of the new complex was demonstrated by its enhanced tumor detection sensitivity in a liver cancer model using in vivo MRI.

A study on the color distribution of natural teeth by age and gender in the Korean population with an intraoral spectrophotometer

OBJECTIVE

To investigate the distribution of natural tooth shades by age and gender in the Korean population with a spectrophotometer.

MATERIAL AND METHODS

A total of 674 human subjects were recruited and divided into three age groups; young (16-30), middle (31-59), and elderly (60-89). Each group was then subdivided according to gender. Color was measured on the upper central incisor and CIELab color coordinates were obtained. CIEDE2000 color differences ( ΔE₀₀ ) between genders within each age group and between age groups for both genders were calculated. Two-way analysis of variance (ANOVA) was used to identify the influence of age and gender on each color variable.

RESULTS

The most frequent color in the Korean population was 2L1.5. L* values decreased, while b* values increased with age (P < .05). There was a significant interaction between gender and age on b* values; F (2668) = 3.489, P = .031, partial η²  = 0.010, and observed power = 0.652. Females generally have lighter and less chromatic central incisors compared to males. The ΔE₀₀ values between genders in elderly groups were beyond acceptability threshold.

CONCLUSIONS

The central incisors were getting darker, more yellowish, and reddish with age. Information on the chromatic range of natural teeth by age and gender could help to select colors for esthetic dental restorations.

CLINICAL SIGNIFICANCE

Dentists should consider an unacceptable color mismatch between the restorations and natural dentition that can occur over time.

Surface Design of Eu-Doped Iron Oxide Nanoparticles for Tuning the Magnetic Relaxivity

Relaxivity tuning of nanomaterials with the intrinsic T₁- T₂ dual-contrast ability has great potential for MRI applications. Until now, the relaxivity tuning of T₁ and T₂ dual-modal MRI nanoprobes has been accomplished through the dopant, size, and morphology of the nanoprobes, leaving room for bioapplications. However, a surface engineering method for the relaxivity tuning was seldom reported. Here, we report the novel relaxivity tuning method based on the surface engineering of dual-mode T₁- T₂ MRI nanoprobes (DMNPs), along with protein interaction monitoring with the DMNPs as a potential biosensor application. Core nanoparticles (NPs) of europium-doped iron oxide (EuIO) are prepared by a thermal decomposition method. As surface materials, citrate (Cit), alendronate (Ale), and poly(maleic anhydride- alt-1-octadecene)/poly(ethylene glycol) (PP) are employed for the relaxivity tuning of the NPs based on surface engineering, resulting in EuIO-Cit, EuIO-Ale, and EuIO-PP, respectively. The key achievement of the current study is that the surface materials of the DMNP have significant impacts on the r₁ and r₂ relaxivities. The correlation between the hydrophobicity of the surface material and longitudinal relaxivity ( r₁) of EuIO NPs presents an exponential decay feature. The r₁ relaxivity of EuIO-Cit is 13.2-fold higher than that of EuIO-PP. EuIO can act as T₁- T₂ dual-modal (EuIO-Cit) or T₂-dominated MRI contrast agents (EuIO-PP) depending on the surface engineering. The feasibility of using the resulting nanosystem as a sensor for environmental changes, such as albumin interaction, was also explored. The albumin interaction on the DMNP shows both T₁ and T₂ relaxation time changes as mutually confirmative information. The relaxivity tuning approach based on the surface engineering may provide an insightful strategy for bioapplications of DMNPs and give a fresh impetus for the development of novel stimuli-responsive MRI nanoplatforms with T₁ and T₂ dual-modality for various biomedical applications.

Evaluation of the repeatability and matching accuracy between two identical intraoral spectrophotometers: an in vivo and in vitro study

PURPOSE

The purpose of this study was to evaluate the repeatability and matching accuracy between two identical intraoral spectrophotometers.

MATERIALS AND METHODS

The maxillary right central incisor, canine, and mandibular left central incisor of each of 30 patients were measured using 2 identical intraoral spectrophotometers with different serial numbers (EasyShade V). The color of each shade tab from 3 shade guides (VITA 3D-Master) was also determined with both devices. All measurements were performed by a single operator. Statistical analyses were performed to verify the repeatability, accuracy, and the differences between the devices with paired t-tests, one-way ANOVA, and intra-class correlation coefficients (ICCs) (α=.05).

RESULTS

A high level of measurement repeatability (ICC>0.90) among L^*, a^*, and b^* color components was observed within and between devices (P<.001). Intra-device matching agreement rates were 80.00% and 81.11%, respectively, while inter-device matching agreement rate was 51.85%. ANOVA revealed no significant different color values within each device, while paired t-test provided significant different color values between both devices. The CIEDE2000 color differences between both devices were 2.28±1.61 ΔE₀₀ for in-vivo readings. Regarding the clinical matching accuracy of both devices, ΔE₀₀ values between teeth and matching shade tabs were 3.05±1.19 and 2.86±1.02, respectively.

CONCLUSION

Although two EasyShade V devices with different serial numbers show high repeatability of CIE L^*, a^*, and b^* measurements, they could provide different color values and shade for the same tooth.

Detection of bovine coronavirus in nasal swab of non-captive wild water deer, Korea

Bovine coronavirus (BCoV) is a causative agent of respiratory and enteric diseases in cattle and calves. BCoV infection was also evident in captive wild ruminants. Recently, water deer are recognized as the most common wildlife to approach farmhouses and livestock barns in Korea. Therefore, we investigated 77 nasal swab samples from non‐captive wild water deer (Hydropotes inermis) between November 2016 and September 2017 and identified three samples positive for coronavirus, indicating potential for respiratory shedding. The full genomic sequences of the water deer coronavirus were closely related to BCoV (>98%). Therefore, effective biosecurity system in bovine farms would be necessary to prevent contact between farm ruminants and free‐ranging wild water deer.

Radiometallic Complexes of DO3A-Benzothiazole Aniline for Nuclear Medicine Theranostics

To develop a radioactive metal complex platform for tumor theranostics, we introduced three radiopharmaceutical derivatives of 1,4,7,10-tetraazacyclododecane-1,4,7-trisacetic acid-benzothiazole aniline (DO3A-BTA, L1) labeled with medical radioisotopes for diagnosis (⁶⁸Ga/⁶⁴Cu) and therapy (¹⁷⁷Lu). The tumor-targeting ability of these complexes was demonstrated in a cellular uptake experiment, in which ¹⁷⁷Lu-L1 exhibited markedly higher uptake in HeLa cells than the ¹⁷⁷Lu-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid complex. According to in vivo positron emission tomography imaging, high accumulation of ⁶⁸Ga-L1 and ⁶⁴Cu-L1 was clearly visualized in the tumor site, while ¹⁷⁷Lu-L1 showed therapeutic efficacy in therapy experiments. Consequently, this molecular platform represents a useful approach in nuclear medicine toward tumor-theranostic radiopharmaceuticals when ⁶⁸Ga-L1 or ⁶⁴Cu-L1 is used for diagnosis, ¹⁷⁷Lu-L1 is used for therapy, or two of the compounds are used in conjunction with each other.

Solid pseudopapillary neoplasm of the pancreas with liver metastasis initially misinterpreted as benign haemorrhagic cyst

Solid pseudopapillary neoplasm (SPN) of the pancreas is considered a low-malignant neoplasm with a good prognosis. However, 5% to 15% of patients with SPNs develop metastatic disease, most commonly in the liver. Metastatic hepatic malignancies that show pseudocystic features are rare. Here we describe the case of a middle-aged female with a cystic liver metastasis from SPN. To the best of our knowledge, SPN with a single cystic liver metastasis has not been described, although these tumours frequently undergo haemorrhagic-cystic degeneration. Thus, in these patients the marked cystic change could be misinterpreted as a benign lesion.

Interregional correlations of glucose metabolism between the basal ganglia and different cortical areas: an ultra-high resolution PET/MRI fusion study using 18F-FDG

Basal ganglia have complex functional connections with the cerebral cortex and are involved in motor control, executive functions of the forebrain, such as the planning of movement, and cognitive behaviors based on their connections. The aim of this study was to provide detailed functional correlation patterns between the basal ganglia and cerebral cortex by conducting an interregional correlation analysis of the ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET) data based on precise structural information. Fifteen participants were scanned with 7-Tesla magnetic resonance imaging (MRI) and high resolution research tomography (HRRT)-PET fusion system using ¹⁸F-FDG. For detailed interregional correlation analysis, 24 subregions of the basal ganglia including pre-commissural dorsal caudate, post-commissural caudate, pre-commissural dorsal putamen, post-commissural putamen, internal globus pallidus, and external globus pallidus and 80 cerebral regions were selected as regions of interest on the MRI image and their glucose metabolism were calculated from the PET images. Pearson's product-moment correlation analysis was conducted for the interregional correlation analysis of the basal ganglia. Functional correlation patterns between the basal ganglia and cerebral cortex were not only consistent with the findings of previous studies, but also showed new functional correlation between the dorsal striatum (i.e., caudate nucleus and putamen) and insula. In this study, we established the detailed basal ganglia subregional functional correlation patterns using ¹⁸F-FDG PET/MRI fusion imaging. Our methods and results could potentially be an important resource for investigating basal ganglia dysfunction as well as for conducting functional studies in the context of movement and psychiatric disorders.