bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of calcination on the electrochemical properties of manganese oxides
Authors: Dong Xinyu , Wang Haifeng , Wang Jiawei , He Yue , Yang Pan , Wang Song , Chen Xiaoliang , Yang Chunyuan , Lu Fanghai
Published: August 2023

Three different crystalline forms of Mn3O4 were successfully prepared by a liquid phase method with different additives.
Observation of magnetic vortex configuration in non-stoichiometric Fe3O4 nanospheres
Authors: Niraula Gopal , Toneto Denilson , Goya Gerardo F. , Zoppellaro Giorgio , Coaquira Jose A. H. , Muraca Diego , Denardin Juliano C. , Almeida Trevor P. , Knobel Marcelo , Ayesh Ahmad I. , Sharma Surender K.
Published: August 2023

Observation of topological magnetic vortex configuration in sub-micron sphere.
Planet formation throughout the Milky Way
Authors: Nielsen Jesper , Gent Matthew Raymond , Bergemann Maria , Eitner Philipp , Johansen Anders
Published: August 2023

As stellar compositions evolve over time in the Milky Way, so will the resulting planet populations. In order to place planet formation in the context of Galactic chemical evolution, we made use of a large (N = 5325) stellar sample representing the thin and thick discs, defined chemically, and the halo, and we simulated planet formation by pebble accretion around these stars. We built a chemical model of their protoplanetary discs, taking into account the relevant chemical transitions between vapour and refractory minerals, in order to track the resulting compositions of formed planets. We find that the masses of our synthetic planets increase on average with increasing stellar metallicity [Fe/H] and that giant planets and super-Earths are most common around thin-disc (α-poor) stars since these stars have an overall higher budget of solid particles. Giant planets are found to be very rare (≲1%) around thick-disc (α-rich) stars and nearly non-existent around halo stars. This indicates that the planet population is more diverse for more metal-rich stars in the thin disc. Water-rich planets are less common around low-metallicity stars since their low metallicity prohibits efficient growth beyond the water ice line. If we allow water to oxidise iron in the protoplanetary disc, this results in decreasing core mass fractions with increasing [Fe/H]. Excluding iron oxidation from our condensation model instead results in higher core mass fractions, in better agreement with the core-mass fraction of Earth, that increase with increasing [Fe/H]. Our work demonstrates how the Galactic chemical evolution and stellar parameters, such as stellar mass and chemical composition, can shape the resulting planet population.
Management of biologics in oral surgery
Authors: Mills Sophie , Ryan Patrick , Gaffney Karl
Published: August 2023

Biologics have revolutionised the management of immune-mediated inflammatory disorders, and their growing use has resulted in increasing numbers of these patients presenting in oral surgery settings. While the efficacy of biologics has been well established, they are associated with numerous adverse effects. Several professional bodies have published recommendations on perioperative management of these agents to reduce complications. Currently no specific dental or oral surgery guidance exists. The aim of this paper is to review the current literature and guidance regarding the use of biologics in the perioperative period.
Modulation of Small-Intestine Morphology in Mice by a Novel Supplement Containing Silybum marianum, Yeast β-Glucan, Prebiotics, and Minerals
Authors: Nucci Ricardo Aparecido Baptista , Nehmi-Filho Victor Abou , Bastos Marta Ferreira , de Freitas Jéssica Alves , Otoch José Pinhata , Pessoa Ana Flávia Marçal , Jacob-Filho Wilson
Published: August 2023

Silymarin, derived from Silybum marianum, has recently demonstrated its potential to improve health in conditions such as obesity and metabolic disturbances. Understanding the impact of nutraceuticals on intestinal morphology is crucial for developing supplements that promote a higher quality of life. Therefore, this study aimed to investigate the effects of nutraceutical supplementation with silymarin on the morphology of the small intestine. Sixty-day-old adult male C57BL/6 mice were divided into two groups: one receiving a standard chow (control) and the other receiving a novel silymarin supplement (experimental). Following the experimental period, the animals were euthanized, and fragments of the small intestine were collected for histochemical analysis using Masson's trichrome and periodic acid-Schiff with Alcian blue staining techniques. Our results revealed an increase in the number of villi per analyzed field in the experimental group, accompanied by a decrease in basic mucin, crypt depth, mucosal thickness, and villus spacing. In conclusion, this novel nutraceutical supplementation may play a crucial role in modulating small intestine morphology and enhancing absorption capacity.
CT MRI LI-RADS in Routine Practice
Authors: Ganesan Karthik , Jalkote Shivsamb , Nellore Swarup
Published: August 2023

Primary liver cancer is the third most common cause of cancer-related deaths worldwide with hepatocellular carcinoma (HCC) comprising the vast majority of the cases. HCC unlike most solid cancers can be diagnosed based on imaging findings alone using multiphasic contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) without the need for histopathological confirmation in the majority of the cases. Liver Imaging Reporting and Data System (LI-RADS) was first introduced by the American College of Radiology in 2011 with the help of a multidisciplinary team of liver disease experts to improve the accuracy, consistency, and clarity of communication of imaging findings between radiologists and treating physicians. To date, LI-RADS has undergone four major updates in 2013, 2014, 2017, and 2018. This article reviews the technical aspects, categorization, and major and ancillary imaging features for the application of LI-RADS version 2018 using CT and MRI in routine clinical practice.
Lessons from Real Life Experience: Importance of In-House Sequencing and Smart Ratio-Based Real-Time PCR Outperform Multiplex Ligation-Dependent Probe Amplification in Prenatal Diagnosis for Spinal Muscular Atrophy: Bench to Bedside Diagnosis
Authors: Tuncel Gulten , Sanlıdag Burcin , Dirik Eray , Baris Tugba , Ergoren Mahmut Cerkez , Temel Sehime Gulsun
Published: August 2023

Spinal muscular atrophy (SMA) is a rare, recessively inherited neurodegenerative disorder caused by the presence of pathogenic variants in the SMN gene. As it is the leading inherited cause of infant mortality, identification of SMN gene pathogenic variant carriers is important for diagnostic purposes with effective genetic counseling. Multiple ligation probe analysis (MLPA), a probe-based method, is considered as the gold standard for SMA carrier analysis. However, MLPA might give false-negative results in cases with variations in the probe-binding regions. Here, we present a case born to consanguineous SMA carrier parents. Prenatal diagnosis with MLPA failed to detect the compound heterozygous mutant state of the proband and she was born unfortunately with SMA phenotype. Further analysis with a real-time polymerase chain reaction kit was able to detect the compound heterozygous state of the patient and was confirmed with targeted next-generation sequencing technology.
MSSA-based adaptive low-frequency noise reduction using spectrum overlap measure
Authors: Kuang Weichao , Yang Ping , Miao Qing , Ling Wing-Kuen
Published: August 2023

A multistage singular spectrum analysis based method is presented to extract the useful component from the residue stage by stage. In every stage of the decomposition, the sum of the signal-dominated SSA components is treated as the denoised signal. The signal-to-noise ratios of the denoised signals first increase and then decrease. A measurement called spectrum overlap factor (SOF) is proposed to estimate the optimal stage which achieves the highest SNR. First, the factor is calculated to measure the spectrum overlap degree between the residue and the denoised signal in every stage. Then, the curve of the SOF with respect to the number of stages is analyzed. Further, the minimum of the SOFs, which indicates the less spectrum overlap, allows for the estimation of the optimal stage. The proposed strategy avoids inappropriate parameter selection effectively since the estimation of the optimal stage is automatic. Besides, simulation results show that the proposed method has satisfactory denoising performance in different test scenarios.
A refractive three-dimensional reconstruction method for fringe projection with a planar medium
Authors: Chen Chao , Li Zhaonan , Lu Wenzhen , Wang Yuzhu , Wang Huaiwen
Published: August 2023

In special measurement situations, a vision measurement system needs to measure objects through a viewing observation window made of a planar transparent medium. The refraction at the interface between a medium and air leads to large measurement errors in the pin-hole imaging model. Most existing solutions require complex processes of calculating refracted light equations and/or matching stereo images. Here, we propose a refractive three-dimensional (3D) reconstruction method for fringe projection with a planar medium. We derive a coordinate conversion relationship from a pseudo-object point caused by light refraction to a real-object point based on flat refractive geometry. Then, we integrate the relationship into regular fringe projection framework for unbiased 3D reconstruction. Two experiments, including 3D shape measurements of a step and a regular sphere are performed. The results verify the effectiveness and accuracy of the proposed refractive 3D reconstruction method.
Absolute continuity of non-homogeneous Gibbs measures of the Ising model on the Cayley tree
Authors: Mukhamedov Farrukh , Khakimov Otabek
Published: August 2023

In this paper, for the Ising model on the Cayley tree of order

k
⩾
2

, a sequence

{

h
n

}

of boundary conditions is constructed depending on an initial value h which defines a Gibbs measure µ

h
. By investigating the dynamical behaviour of the renormalisation group map associated with the model, we prove that each measure µ

h
is equivalent to the disordered phase

μ
∗

. This result shines a new light to the question closely related to the classical result by Kakutani which asserts that any two locally-equivalent probability product measures are either equivalent or mutually-singular.
Towards simulation-free MR-linac treatment: utilizing male pelvis PSMA-PET/CT and population-based electron density assignments
Authors: Carr Madeline E , Jelen Urszula , Picton Maddison , Batumalai Vikneswary , Crawford David , Peng Valery , Twentyman Tania , de Leon Jeremy , Jameson Michael G
Published: August 2023

Objective. This study aimed to investigate the dosimetric impact of using population-based relative electron density (RED) overrides in lieu of simulation computerized tomography (CT) in a magnetic resonance linear accelerator (MRL) workflow for male pelvis patients. Additionally, the feasibility of using prostate specific membrane antigen positron emission tomography/CT (PSMA-PET/CT) scans to assess patients’ eligibility for this proposed workflow was examined. Approach. In this study, 74 male pelvis patients treated on an Elekta Unity 1.5 T MRL were retrospectively selected. The patients’ individual RED values for 8 organs of interest were extracted from their simulation-CT images to establish population-based RED values. These values were used to generate individual (IndD) and population-based (PopD) RED dose plans, representing current and proposed MRL workflows, respectively. Lastly, this study compared RED values obtained from CT and PET-CT scanners in a phantom and a subset of patients. Results. Population-based RED values were mostly within two standard deviations of ICRU Report 46 values. PopD plans were comparable to IndD plans, with the average %difference magnitudes of 0.5%, 0.6%, and 0.6% for mean dose (all organs), D0.1cm
3 (non-target organs) and D95%/D98% (target organs), respectively. Both phantom and patient PET-CT derived RED values had high agreement with corresponding CT-derived values, with correlation coefficients ≥ 0.9. Significance. Population-based RED values were considered suitable in a simulation-free MRL treatment workflow. Utilizing these RED values resulted in similar dosimetric uncertainties as per the current workflow. Initial findings also suggested that PET-CT scans may be used to assess prospective patients’ eligibility for the proposed workflow. Future investigations will evaluate the clinical feasibility of implementing this workflow for prospective patients in the clinical setting. This is aimed to reduce patient burden during radiotherapy and increase department efficiencies.
HIRA: Heart Rate Interval based Rapid Alert score to characterize autonomic dysfunction among patients with sepsis-related acute respiratory failure (ARF)
Authors: Krishnan Preethi , Rad Milad G , Agarwal Palak , Marshall Curtis , Yang Philip , Bhavani Sivasubramanium V , Holder Andre L , Esper Annette , Kamaleswaran Rishikesan
Published: August 2023

Objective. To examine whether heart rate interval based rapid alert (HIRA) score derived from a combination model of heart rate variability (HRV) and modified early warning score (MEWS) is a surrogate for the detection of acute respiratory failure (ARF) in critically ill sepsis patients. Approach. Retrospective HRV analysis of sepsis patients admitted to Emory healthcare intensive care unit (ICU) was performed between sepsis-related ARF and sepsis controls without ARF. HRV measures such as time domain, frequency domain, and nonlinear measures were analyzed up to 24 h after patient admission, 1 h before the onset of ARF, and a random event time in the sepsis controls. Statistical significance was computed by the Wilcoxon Rank Sum test. Machine learning algorithms such as eXtreme Gradient Boosting and logistic regression were developed to validate the HIRA score model. The performance of HIRA and early warning score models were evaluated using the area under the receiver operating characteristic (AUROC). Main Results. A total of 89 (ICU) patients with sepsis were included in this retrospective cohort study, of whom 31 (34%) developed sepsis-related ARF and 58 (65%) were sepsis controls without ARF. Time-domain HRV for Electrocardiogram (ECG) Beat-to-Beat RR intervals strongly distinguished ARF patients from controls. HRV measures for nonlinear and frequency domains were significantly altered (p < 0.05) among ARF compared to controls. The HIRA score AUC: 0.93; 95% confidence interval (CI): 0.88–0.98) showed a higher predictive ability to detect ARF when compared to MEWS (AUC: 0.71; 95% CI: 0.50–0.90). Significance. HRV was significantly impaired across patients who developed ARF when compared to controls. The HIRA score uses non-invasively derived HRV and may be used to inform diagnostic and therapeutic decisions regarding the severity of sepsis and earlier identification of the need for mechanical ventilation.
Aligning incentives for carbon dioxide removal
Authors: Reinhard Christopher T , Planavsky Noah J , Khan Anu
Published: August 2023

Carbon dioxide removal (CDR) at the scale needed to meet key climate goals will require the development of a massive industry. The development of regulatory architecture and effective incentive structures must proceed in parallel if this industry is to function in a way that is technically rigorous, environmentally conscious, and socially responsible. Most of the current capital flow, overall technological development in CDR, and third-party monitoring and verification are occurring in the private sector. We argue here that this will need to change in order for robust, responsible carbon removal to be brought to scale. In the short term, a focus on removing flawed incentive structures will be a critical ingredient in the transition to a stable, large-scale marketplace for durable carbon removal.
Tracking and curating putative SARS-CoV-2 recombinants with RIVET
Authors: Smith Kyle , Ye Cheng , Turakhia Yatish
Published: August 2023

Motivation

Identifying and tracking recombinant strains of SARS-CoV-2 is critical to understanding the evolution of the virus and controlling its spread. But confidently identifying SARS-CoV-2 recombinants from thousands of new genome sequences that are being shared online every day is quite challenging, causing many recombinants to be missed or suffer from weeks of delay in being formally identified while undergoing expert curation.

Results

We present RIVET—a software pipeline and visual platform that takes advantage of recent algorithmic advances in recombination inference to comprehensively and sensitively search for potential SARS-CoV-2 recombinants and organize the relevant information in a web interface that would help greatly accelerate the process of identifying and tracking recombinants.

Availability and implementation

RIVET-based web interface displaying the most updated analysis of potential SARS-CoV-2 recombinants is available at https://rivet.ucsd.edu/. RIVET’s frontend and backend code is freely available under the MIT license at https://github.com/TurakhiaLab/rivet and the documentation for RIVET is available at https://turakhialab.github.io/rivet/. The inputs necessary for running RIVET’s backend workflow for SARS-CoV-2 are available through a public database maintained and updated daily by UCSC (https://hgdownload.soe.ucsc.edu/goldenPath/wuhCor1/UShER_SARS-CoV-2/).
Anuran swingers: misdirected mating attempts occurred early during anuran diversification
Authors: Brischoux François , Lorrain-Soligon Léa
Published: August 2023

Promiscuity, explosive breeding and male-biased operational sex-ratios can affect the strength of male selectivity and may play major roles in the expression of misdirected matings (with conspecific males, other species, corpses or objects) in anuran amphibians. Yet, misdirected amplexus occur in multiple species diverging from these reproductive traits, suggesting that the expression of such behaviour is widespread, and may have occurred early during anuran diversification. Using two methods of ancestral-trait reconstruction which predict unknown states, we found a very high probability that most anuran genera express misdirected amplexus, suggesting that this by-product of anuran reproductive strategies is likely to have occurred early during anuran diversification. The persistence of misdirected amplexus suggests that its infrequent occurrence may outweigh individual costs of breeding attempts with unfit mates. We found a recent exponential increase in reported observations of misdirected amplexus, which, along with increased research effort and publication rate, may reveal an effect of environmental perturbations known to promote the occurrence of these behaviours.
Deep Kronecker network
Authors: Feng Long , Yang Guang
Published: August 2023

We develop a novel framework for the analysis of medical imaging data, including magnetic resonance imaging, functional magnetic resonance imaging, computed tomography and more. Medical imaging data differ from general images in two main aspects: (i) the sample size is often considerably smaller and (ii) the interpretation of the model is usually more crucial than predicting the outcome. As a result, standard methods such as convolutional neural networks cannot be directly applied to medical imaging analysis. Therefore, we propose the deep Kronecker network, which can adapt to the low sample size constraint and offer the desired model interpretation. Our approach is versatile, as it works for both matrix- and tensor-represented image data and can be applied to discrete and continuous outcomes. The deep Kronecker network is built upon a Kronecker product structure, which implicitly enforces a piecewise smooth property on coefficients. Moreover, our approach resembles a fully convolutional network as the Kronecker structure can be expressed in a convolutional form. Interestingly, our approach also has strong connections to the tensor regression framework proposed by Zhou et al. (2013), which imposes a canonical low-rank structure on tensor coefficients. We conduct both classification and regression analyses using real magnetic resonance imaging data from the Alzheimer’s Disease Neuroimaging Initiative to demonstrate the effectiveness of our approach.
Put your publication money where your mouth is
Authors: Spires-Jones Tara L , Belin David
Published: August 2023

Two members of our Editorial Board discuss how the proceeds from article processing charges from Brain Communications and our sister journal Brain are put back into the translational neuroscience community.
264. A RETROSPECTIVE CHART REVIEW OF 85 PATIENTS UNDERGOING THE REFLUXSTOP PROCEDURE TO MANAGE GASTROESOPHAGEAL REFLUX DISEASE: SAFETY AND EFFICACY
Authors: Lehmann Thorsten , Simkus Mantas , Oehler Christoph
Published: August 2023

Background

RefluxStop is a novel surgical device that manages gastroesophageal reflux disease (GERD) by restoring the normal structure of the antireflux barrier. This is accomplished by reinstating the acute angle of His and anchoring the gastroesophageal sphincter adequately in the intraabdominal cavity. This study reports the safety and efficacy of 79 patients in the postoperative period.

Methods

A retrospective chart review was performed on 79 patients that underwent the RefluxStop procedure at a single institution between July 2021 and November 2022 to manage GERD symptoms after informed consent was obtained. Measures were evaluated to assess the feasibility, safety, and clinical outcomes during the follow-up period.

Results

79 patients (age 49.8 ± 14 years), 46 of which were male, had a mean BMI of 25.8 ± 4.5. Associated conditions noted included esophagitis (45.6%), Barrett’s esophagus (17.7%), and hiatal hernia (57%). Hiatal hernias were large in 35% of cases, with an overall average size of 2.9 cm. Baseline symptoms included general GERD symptoms (35.4%), heartburn (29.1%), cough (13.9%), regurgitation (11.4%), retrosternal burning (10.1%), hoarseness (5.1%), abdominal pain or pressure (3.8%), nausea (2.5%), and others. Baseline GERD health-related quality of life (GERD-HRQL) score was 21.5 ± 5.2 and patients were receiving proton pump inhibitors (PPIs) for a mean of 4.7 ± 6.8 years. After surgery (10.7 ± 3.1 months), all subjects experienced significant improvement in GERD-related symptoms including dysphagia. Only 2.5% of patients required use of PPIs and no subjects required postoperative esophageal dilatation or reoperation. Additionally, there were no severe perioperative complications. Postoperatively, the mean GERD-HRQL score was significantly reduced to 1.6 ± 3.2 (92.6% improvement).

Conclusion

This study adds to a growing body of evidence that the RefluxStop procedure is safe and effective in management of GERD patients. Notably, a considerable improvement in PPI usage and health-related quality of life parameters were appreciated. Additional studies are required to further validate the role of this procedure in disease management.
307. A REVIEW OF 31 SUPERFICIAL ESOPHAGEAL CANCER CASES WITHOUT HISTORY OF HABITUAL DRINKING OR SMOKING OBSERVED IN OUR HOSPITAL
Authors: Ishiyama Akiyoshi , Fukuyama Chika , Yamamoto Hiroyuki , Ikenoyama Yohei , Namikawa Ken , Tokai Yoshitaka , Yoshio Toshiyuki , Fujisaki Junko
Published: August 2023

Background

In Japan, alcohol consumption, smoking, and genetic an aldehyde dehydrogenase 2 polymorphisms are risk factors for most esophageal squamous cell carcinomas(ESCC). However, only a limited number of cases have been observed without these risk factors in daily practice.

Objective

This study aimed to evaluate the endoscopic findings of 31 lesions in 29 patients with ESCC who underwent endoscopic submucosal dissection (ESD) at our hospital without a history of habitual alcohol consumption or smoking (hereafter referred to as ‘risk factors’).

Patients and Methods: We retrospectively examined the endoscopic findings, final diagnoses, and patient and lesion backgrounds of 31 lesions from 29 patients of ESCC without risk factors who underwent ESD from January 2017 to December 2022 at our hospital.

Results

A total of 27 women and two men, median age 72 (44–87) years, were included; 10 patients were on proton pump inhibitors, 12 patients had a history of cancer, and 12 patients had a family history of cancer in the first degree. Additionally, three patients had multiple heterochronic lesions, one patient had a speckled esophagus, and two patients had grade B gastroesophageal reflux disease according to the revised Los Angeles classification. Occupied site; Ut/Mt/Lt = 4/24/3, circumferential; anterior/posterior/left/right wall = 0/16/10/5, macroscopic type; 0-IIa/0-IIb/0-IIc/mixed type = 4/10/15/2, median lesion length 17(5–45) mm, wall depth; EP/LPM/MM/SM1 = 11/18/1/1/1, all vascular invasions were negative. A total of 22 lesions had white-tone mucosa on their surface, suggesting superficial keratinization or hyperkeratinization. The lesions were diverse in shape. Additionally, seven lesions were observed which tended to run longitudinally with long axial lengths, all located on the posterior wall of Mt, and white adherent material was observed in six lesions. Iodine staining was performed in 30 lesions, all of which were unstained, and six of them had indistinct borders with inflammatory changes in the background. A total of three patients had synchronous/heterochronic multiple esophageal cancers.

Conclusion

The white adherents running longitudinally in the posterior wall of the Mt and its white tone in patients with no risk factors suggest the possibility of previously unrecognized lesions and the need for close endoscopic examination, along with iodine staining and biopsy.
322. FLUORESCENCE LYMPHOGRAPHY USING INDOCYANINE GREEN IN THE PREVENTION OF CHYLE LEAKAGE AFTER MINIMALLY INVASIVE ESOPHAGECTOMY
Authors: Aa Dillen , Henckens Sophie , Eshuis Wietse J , Berge Henegouwen Mark , Gisbertz Suzanne
Published: August 2023

Background

Chyle leakage is one of the most challenging complications in esophagectomy, with an incidence of 14–21%. The clinical implications for patients are prolonged thoracic drainage and hospital admission, additional reinterventions, unpleasant dietary restrictions, and decreased long-term survival. The anatomy and vulnerability of the thoracic duct render it prone to injury, and mainly side branches and collaterals are often hard to visualize. Fluorescence lymphography using indocyanine green (ICG) can accurately visualize the thoracic duct, which may possibly reduce the incidence of chyle leakage and intra-operative detected chyle leakage can be treated directly.

Methods

A prospective observational cohort study is performed. Patients aged over 18 years with resectable (cT1-4a, N0–3, M0) esophageal carcinoma undergoing a minimally invasive esophagectomy are included. The primary endpoint of the study is postoperative chyle leakage. Secondary endpoints are overall morbidity and mortality, nature of dietary restrictions, reinterventions, hospital costs, 2 year survival rate and quality of life. Twenty-five milligram of ICG is dissolved in 10 mL of sterile water, obtaining a solution of 2.5 mg ICG per mL. In the McKeown esophagectomy, before the thoracic phase, the surgeon administers a bilateral bolus of 2 mL ultrasound-guided into inguinal lymph nodes. In an Ivor Lewis esophagectomy, 2 mL of reconstituted ICG will be injected into the small bowel mesenteric root just under the peritoneum of the mesentery, at the level where the jejunostomy is placed. Additionally, 50 mL of cream is enterally administered through the just established feeding jejunostomy. Subsequently, the operating area is inspected for chyle leakage with fluorescence lymphography after thoracic duct ligation and just before terminating the procedure.

Results

We aim to include 50 patients to assess the feasibility of fluorescent lymphography using ICG and enteral cream to prevent chyle leakage after minimally esophagectomy. Inclusion is ongoing, at this time, 31 of 50 patients are included. Results will be expected before the congress.

Conclusion

It is hypothesized that as a result of this technique the patients will benefit from lower incidence of postoperative chyle leakage, shorter thoracic drainage, reduced hospital admission, reduced dietary restriction, less re-interventions, and improved overall survival.
343. T LYMPHOCYTE SUBSETS CHARACTERISTICS IN DIFFERENT CURATIVE EFFICACY OF NEOADJUVANT THERAPY FOR PATIENTS WITH ESOPHAGEAL SQUAMOUS CELL CARCINOMA
Authors: Nie Xin , He Shuya , He Wenwu , Li Zhiyu , Li Changding , Ni Kunhan , Leng Xuefeng , Han Yongtao , Wang Chenghao
Published: August 2023

Background

In patients with resectable esophageal squamous cell carcinoma(ESCC), neoadjuvant therapy increased the curative resection rate, disease-free survival, and overall survival. Up to 32% of patients with esophageal cancer show a pathological complete response after neoadjuvant therapy. However, the efficacy of neoadjuvant therapy varies among different patients. We aim to compare the differences in the characteristics of peripheral blood T lymphocyte subsets before and after neoadjuvant therapy in patients with different curative efficacy.

Methods

This study enrolled 269 ESCC patients who received neoadjuvant treatment followed by esophagectomy planned 4–6 weeks after preoperative therapy. The postoperative pathological results divided patients into the main pathological response (MPR) and non-MPR groups. Compare the differences in peripheral blood T lymphocyte subsets before neoadjuvant therapy, and analyze the trend of changes in T lymphocyte subsets before neoadjuvant therapy, before surgery, in the short term after surgery, and at the initial follow-up after surgery.

Results

Before receiving neoadjuvant therapy, the peripheral blood CD4/CD8(p = 0.001) and helper T cell rate (THrate)(p = 0.006) in the MPR group were significantly higher than those in the non-MPR group. In contrast, the suppressor T cell rate(TSrate) was lower(p = 0.029) in the MPR group. After neoadjuvant therapy, the CD4/CD8 in both groups reached similar classes, but the THrate decreased dramatically and TSrate increased more in the MPR group. At the first follow-up after surgery, the peripheral blood CD4/CD8, THrate, and TSrate of both groups of patients tended to be at the same level.

Conclusion

T lymphocyte subsets in the peripheral blood significantly differed among patients with different neoadjuvant treatment efficacy. High levels of CD4/CD8, THrate, and low levels of TSrate before receiving neoadjuvant therapy may have better curative efficacy.
371. THE FEASIBILITY OF MINIMALLY INVASIVE SALVAGE ESOPHAGECTOMY
Authors: Tsunoda Shigeru , Nishigori Tatsuto , Hisamori Shigeo , Okumura Shintaro , Maekawa Hisatsugu , Fujita Yusuke , Kasahara Keiko , Morimoto Tomonori , Kinoshita Hiromitsu , Sakamoto Takashi , Mihara Kaito , Okamura Ryosuke , Itatani Yoshiro , Hoshino Nobuaki , Hida Koya , Obama Kazutaka
Published: August 2023

Background

The mortality of salvage esophagectomy following definitive chemoradiotherapy for esophageal cancer is reported to be high and the feasibility of a minimally invasive approach for salvage esophagectomy remains unknown. The aim of the study is to investigate the feasibility of a minimally invasive approach for salvage esophagectomy.

Methods

Consecutive 34 patients including 6 pharyngolaryngectomy with total esophagectomy who underwent salvage esophagectomy for esophageal cancer after chemoradiotherapy of 50Gy or greater between 2011 and 2023 were retrospectively reviewed. Postoperative complications were graded according to the Clavien-Dindo classifications. Our strategy for salvage esophagectomy is as follows; subcarinal dissection and upper mediastinal dissection were omitted unless lymph node involvement was suspected to preserve the tracheal perfusion. Cervical supercharge for the conduit is actively considered if the perfusion is uncertain.

Results

The median age was 64 (45–78). Clinical T stages were T1/T2/T3/T4: 2/8/19/5. The thoracic approaches are conventional thoracoscopy (n = 23), robot-assisted thoracoscopy (n = 9), and mediastinoscopy (n = 2), and no patients underwent open thoracotomy. Cervical supercharge was performed in 16 (47%) patients. The median operation time and blood loss were 673 min and 101 g, respectively. Severe postoperative complications (≧Grade III) occurred in 4 (12%) patients and any postoperative complications (≧Grade II) occurred in 19 (56%) patients, including 6 (18%) anastomotic leakage and 5 (15%) pneumonia. There was no mortality. The 3- and 5-year overall survival rate was 82% and 69%, respectively.

Conclusion

The minimally invasive approach for salvage esophagectomy was safe and feasible in terms of short- and long-term outcomes.
416. FEASIBILITY STUDY ON THE INTRA-OPERATIVE USE OF IMPEDANCE PLANIMETRY (ENDOFLIP) TO ASSESS PYLORIC FUNCTION DURING ESOPHAGECTOMY
Authors: Bolger Jarlath , Wakeam Elliot , Yeung Jonathan
Published: August 2023

Background

Esophagectomy remains the cornerstone of curative treatment of esophageal cancer. Despite this, the optimal management of the pylorus remains unclear. In open surgery, a pyloroplasty, pyloromyotomy or finger fracture of the pylorus has been standard. In minimally invasive surgery, pyloric procedures are frequently excluded. Approximately 16% of patients will subsequently require endoscopic dilation of their pylorus due to issues with conduit function. Conversely, those with a pyloric procedure have significantly higher rates of dumping. The aim of this feasibility study is to determine whether intra-operative impedance planimetry (EndoFLIP) assessment of the pylorus may help identify those who will benefit from an up-front pyloric procedure.

Methods

20 consecutive patients undergoing esophagectomy for esophageal cancer were consented and enrolled. At the conclusion of the operative procedure, when assessing the anastomosis and conduit endoscopically, the EndoFLIP catheter was passed with the endoscope. Diameter of the pyloric lumen and distensibility index (DI) were recorded for a range of balloon pressures.

Results

There were significant variations in lumen diameter and DI between patients. Mean lumen diameter with 30 mL balloon volume is 8.3 mm (5.1–11.3), with 40 mL balloon volume is 12.5 mm (11.6–13.8), and with 50 mL balloon volume is 14.9 mm (13.9–15.9). Mean DI at 30 mL is 5.77 (1.35–13.5), at 40 mL is 8.64 (4.59–17.0) and at 50 mL is 12.7 (3.56–38.0).

Conclusion

EndoFLIP assessment of pyloric function is feasible during esophagectomy. There are significant variations in pyloric measurements between patients. This may allow personalised management of the pylorus for patients undergoing minimally invasive esophagectomy.
441. COMBINING LARYNGEAL ULTRASONOGRAPHY (LUSG) WITH VOICE ASSESSMENT OR INTRA-OPERATIVE NERVE MONITORING RESULTS ACCURATELY CONFIRMS NORMAL VOCAL CORD FUNCTION AFTER ESOPHAGECTOMY
Authors: Fung Man Him Matrix , Wong Ian , Chan Fion Siu-Yin , Law Tsz-Ting , Chan Kwan-Kit , Wong Claudia Lai-Yin , Lang Brian Hung-Hin , Law Simon Ying-Kit
Published: August 2023

Background

Conventional diagnosis of vocal cord paresis (VCP) after esophagectomy relies on flexible laryngoscopy (FL), which is invasive. As most patients had normal post-operative VC function, a non-invasive alternative such as laryngeal ultrasonography (LUSG) may avoid unnecessary FL. LUSG was well-known to be accurate for post-thyroidectomy VC evaluation, but its accuracy following esophagectomy was unclear. This prospective study assessed the feasibility and accuracy of LUSG to evaluate VC function on day-1 after esophagectomy.

Methods

Consecutive patients from a tertiary teaching hospital who underwent elective esophagectomy were prospectively recruited. All patients received FL and LUSG pre-operative and on post-operative Day-1, each performed by an independent, experienced blinded assessor. Exclusion criteria include pre-operative VCP and lost to VC evaluation at any time points. The primary outcome was the accuracy of LUSG in the diagnosis of VCP on Day-1 post-esophagectomy. The accuracy of intermittent intra-operative nerve monitoring (IIONM) and voice assessment (VA) after surgery for the diagnosis of VCP were also analyzed.

Results

Twenty-six patients were eligible for analysis. The median age was 70 years (66–73). Majority were male (84.6%) and had squamous cell carcinoma. (88.5%). Twenty-five (96.2%) received three-phase esophagectomy. Twenty-four (96%) had anastomosis at the neck at the same stage. There were three (11.5%) temporary and one (3.8%) permanent unilateral VCP. Sensitivity, specificity and accuracy of LUSG were 75.0%, 100.0% and 98.1% respectively, which were superior to IIONM alone (50%, 90.3%, 87.9%) or VA alone (50%, 90.9%, 84.6%). Combining LUSG with VA or IIONM improved sensitivity and negative predictive value to 100.0% and could avoid 77% FLs.

Conclusion

LUSG is an accurate method to evaluate VC function in the early post-operative period after esophagectomy. Combining LUSG with VA or IIONM results accurately confirms normal VC function after esophagectomy, and can avoid a majority of FLs.
446. VOCAL FOLD AUGMENTATION REDUCES PNEUMONIA INCIDENCE IN PATIENTS WITH IATROGENIC RECURRENT LARYNGEAL NERVE PALSY AFTER ESOPHAGECTOMY
Authors: Li Ricardo , Wong Ian , Zhang Riki , Wong Claudia , Chan K K , Law Betty , Chan S Y , Law Simon
Published: August 2023

Background

Recurrent laryngeal nerve (RLN) palsy is a significant complication associated with esophagectomy, resulting in a high incidence of pneumonia and a poor quality of life. Vocal fold augmentation (VFA) can help alleviate the associated symptoms of dysphonia. We aimed to investigate the impact of VFA on pneumonia incidence in patients suffering from RLN palsy after esophagectomy.

Methods

This is a retrospective cohort study. Patients who underwent esophagectomy at our center from 2003 to 2022, and experienced right, left or bilateral RLN palsy postoperatively were selected from a prospectively managed database. VFA consisted of medialisation thyroplasty, injection laryngoplasty, arytenoid adduction or a combination of these procedures. Pneumonia was defined as lung changes on chest x-ray, along with clinical evidence of infection within six months after esophagectomy. Pearson’s chi-squared test was used to assess the difference in pneumonia rates. Univariate and multivariate logistic regression analyses were used to identify associations between variables and the outcome of pneumonia.

Results

A total of 107 esophagectomy patients with RLN palsy were included. The overall palsy rate was 14.5%. 41 patients (38.3%) underwent VFA. Of the patients who underwent VFA, 13 (31.7%) underwent medialization thyroplasty, 26 (63.4%) underwent injection laryngoplasty, 1 (2.4%) underwent injection laryngoplasty and medialization thyroplasty, and 1 (2.4%) underwent injection laryngoplasty and arytenoid adduction. Pneumonia rate (14.6%) for patients who underwent VFA was significantly lower than that of patients without VFA (47.0%, P < 0.001). On univariate and multivariate analyses, patients who underwent VFA were less likely to suffer from pneumonia compared to those without VFA (OR = 0.194, P = 0.001).

Conclusion

Vocal fold augmentation reduces pneumonia incidence in patients with recurrent laryngeal nerve palsy after esophagectomy.
Mesalazine-induced myopericarditis: a case series
Authors: Andrei Valentina , D’Ettore Nicoletta , Scheggi Valentina , di Mario Carlo
Published: August 2023

Background

Inflammatory bowel diseases (IBD) are characterized by chronic inflammation of the gastrointestinal tract but can have multiorgan involvement. Mesalazine (5-ASA) is a key therapeutic agent in IBD. Mesalazine has rare but potentially life-threatening side effects such as cardiac injury.

Case summary

We present two cases of myopericarditis, documented also with cardiac magnetic resonance, that we attributed to 5-ASA hypersensitivity: the first is a young woman with ulcerative colitis who developed myopericarditis after the initiation of 5-ASA, with a good clinical response after discontinuation; the second is a 79-year-old man who developed symptoms of heart failure after the diagnosis of IBD and the introduction of 5-ASA.

Discussion

Mesalazine may cause rare but potentially life-threatening cardiac injury, which can be difficult to distinguish from acute IBD-induced cardiac inflammation.
Butler Machine Tool Co. Ltd v Ex-Cell-O Corporation (England) Ltd [1979] 1 WLR 401, Court of Appeal
Authors: Jackson Nicola
Published: August 2023

Essential Cases: Contract Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in Butler Machine Tool Co. Ltd v Ex-Cell-O Corporation (England) Ltd [1979] 1 WLR 401. The document also includes supporting commentary from author Nicola Jackson.
Entores Ltd v Miles Far East Corporation [1955] 2 QB 327
Authors: Jackson Nicola
Published: August 2023

Essential Cases: Contract Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in Entores Ltd v Miles Far East Corporation [1955] 2 QB 327. The document also includes supporting commentary from author Nicola Jackson.
Central London Property Trust Ltd v High Trees House Ltd [1947] KB 130
Authors: Jackson Nicola
Published: August 2023

Essential Cases: Contract Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in Central London Property Trust Ltd v High Trees House Ltd [1947] KB 130. The document also includes supporting commentary from author Nicola Jackson.
Pao On & others v Lau Yiu Long and another [1980] AC 614
Authors: Jackson Nicola
Published: August 2023

Essential Cases: Contract Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in Pao On & others v Lau Yiu Long & another [1980] AC 614. The document also includes supporting commentary from author Nicola Jackson.
Shogun Finance Ltd v Hudson [2003] UKHL 62
Authors: Jackson Nicola
Published: August 2023

Essential Cases: Contract Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in Shogun Finance Ltd v Hudson [2003] UKHL 62. The document also includes supporting commentary from author Nicola Jackson.
Times Travel (UK) Ltd v Pakistan International Airlines Corporation [2021] UKSC 40; [2021] 3 WLR 727
Authors: Jackson Nicola
Published: August 2023

Essential Cases: Contract Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in Times Travel (UK) Ltd v Pakistan International Airlines Corporation [2021] UKSC 40; [2021] 3 WLR 727. The document also includes supporting commentary from author Nicola Jackson.
Royal Bank of Scotland v Etridge (No.2) [2001] UKHL 44
Authors: Jackson Nicola
Published: August 2023

Essential Cases: Contract Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in Royal Bank of Scotland v Etridge (No. 2) [2001] UKHL 44. The document also includes supporting commentary from author Nicola Jackson.
George Mitchell (Chesterhall) Ltd v Finney Lock Seeds Ltd [1983] 2 AC 803
Authors: Jackson Nicola
Published: August 2023

Essential Cases: Contract Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in George Mitchell (Chesterhall) Ltd v Finney Lock Seeds Ltd [1983] 2 AC 803. The document also includes supporting commentary from author Nicola Jackson.
L Schuler AG v Wickman Machine Tool Sales Ltd [1974] AC 235
Authors: Jackson Nicola
Published: August 2023

Essential Cases: Contract Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in L Schuler AG v Wickman Machine Tool Sales Ltd [1974] AC 235. The document also includes supporting commentary from author Nicola Jackson.
Davis Contractors Ltd v Fareham Urban District Council [1956] AC 696
Authors: Jackson Nicola
Published: August 2023

Essential Cases: Contract Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in Davis Contractors Ltd v Fareham Urban District Council [1956] AC 696. The document also includes supporting commentary from author Nicola Jackson.
J. Lauritzen v Wijsmuller (The ‘Super Servant Two’) [1990] 1 Lloyd’s Rep 1
Authors: Jackson Nicola
Published: August 2023

Essential Cases: Contract Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in J. Lauritzen v Wijsmuller (The ‘Super Servant Two’) [1990] 1 Lloyd’s Rep 1. The document also includes supporting commentary from author Nicola Jackson.
Farley v Skinner [2001] UKHL 49
Authors: Jackson Nicola
Published: August 2023

Essential Cases: Contract Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in Farley v Skinner [2001] UKHL 49. The document also includes supporting commentary from author Nicola Jackson.
Ruxley Electronics and Construction Ltd v Forsyth [1996] AC 344
Authors: Jackson Nicola
Published: August 2023

Essential Cases: Contract Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in Ruxley Electronics and Construction Ltd v Forsyth [1996] AC 344. The document also includes supporting commentary from author Nicola Jackson.
Victoria Laundry (Windsor) Ltd v Newman Industries Ltd [1949] 2 KB 528
Authors: Jackson Nicola
Published: August 2023

Essential Cases: Contract Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in Victoria Laundry (Windsor) Ltd v Newman Industries Ltd [1949] 2 KB 528. The document also includes supporting commentary from author Nicola Jackson.
Watts & another v Morrow [1991] 1 WLR 1421
Authors: Jackson Nicola
Published: August 2023

Essential Cases: Contract Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in Watts & another v Morrow [1991] 1 WLR 1421. The document also includes supporting commentary from author Nicola Jackson.
Re Barlow’s Will Trusts [1979] 1 WLR 278, Chancery Division
Authors: Whayman Derek
Published: August 2023

Essential Cases: Equity & Trusts provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in Re Barlow’s Will Trusts [1979] 1 WLR 278, Chancery Division. The document also includes supporting commentary from author Derek Whayman.
Hunter v Moss [1994] 1 WLR 452, Court of Appeal
Authors: Whayman Derek
Published: August 2023

Essential Cases: Equity & Trusts provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in Hunter v Moss [1994] 1 WLR 452, Court of Appeal. The document also includes supporting commentary from author Derek Whayman.
Re Goldcorp Exchange Ltd [1995] 1 AC 74, Privy Council
Authors: Whayman Derek
Published: August 2023

Essential Cases: Equity & Trusts provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in Re Goldcorp Exchange Ltd [1995] 1 AC 74, Privy Council. The document also includes supporting commentary from author Derek Whayman.
Neville Estates v Madden [1962] Ch 832, Chancery Division
Authors: Whayman Derek
Published: August 2023

Essential Cases: Equity & Trusts provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in Neville Estates v Madden [1962] Ch 832, Chancery Division. The document also includes supporting commentary from author Derek Whayman.