The use of percutaneous thermal sensing microchips for non-invasive measurement of body temperature in foals during summer seasons in a subtropical region

Continuous accurate attainment of the body temperature of foals is important to detect early stages of severe heat stress or fever due to a systemic illness. Among a number of methods to measure body temperature, measuring rectal temperature with a digital thermometer is most frequently used due to being relatively fast and simple method. It is also comparatively accurate and correlates well with the core body temperature. However, this method requires restraining the foal for a few seconds to obtain the temperature, and it can be dangerous for the handling person. Percutaneous thermal sensing microchips (PTSMs) are a means of monitoring the body temperature of horses, which offers a non-invasive, hygienic, quick, and accurate way to measure body temperature and provide an identification number for each individual, once it is implanted. This study tested the hypothesis that PTSM has a strong relationship with a conventional body temperature measurement, i.e., measuring rectal temperature with a digital thermometer of foals during summer seasons. Thirty-two foals in three consecutive foaling seasons (2018, 2019, and 2020 season) were implanted a PTSM into the right pectoral muscle, the right splenius muscle, the right gluteal muscle, and the nuchal ligament as early as two weeks after birth. The four PTSM temperatures, rectal temperature, and climate conditions (air temperature, relative humidity, and wet-bulb globe temperature) were obtained simultaneously during the three summer seasons and paired for comparison analysis. Among the PTSM temperatures, the pectoral muscle had the highest correlation and the least differences with rectal temperature. Using PTSM was safe, easy, and reliable for attaining body temperature in foals.

Gender bias in the primary prevention of cardiovascular disease

Funding Acknowledgements

Type of funding sources: None.

Background/introduction

Women receive less aggressive treatment for cardiovascular disease (CVD), partly due to a delayed or incorrect diagnosis. However, there is little research into whether this gender bias extends to primary prevention of CVD (i.e. prevention of CVD in those individuals with no prior CVD events), and the reasons behind this bias.

Purpose

This study analysed gender differences in the primary prevention of CVD in the USA, using data from the National Health and Nutrition Examination Survey (NHANES) for the years 2015-2018. It also explored the drivers behind these differences. The hypothesis was that the known gender bias in CVD treatment also extends to primary prevention.

Methods

The risk of developing CVD over the next ten years was calculated using the Pooled Cohort Equations (PCEs) for 9,623 healthy men and women aged 40 to 79 years. 3,035 participants were found to be at higher CVD risk (ASCVD score above 7.5%) and potentially eligible for statins. Individuals with prior diagnosis of CVD were excluded from this study. Multivariable logistic regression was used to calculate adjusted odds ratios (AOR) in the usage of preventive treatment between genders.

Results

The results showed that men were 21% more likely to be prescribed statins than women whilst women were 20-37% more likely to be told to make behaviour modifications than men (Table 1). An interdisciplinary literature review showed that lower CVD risk perception in women is a likely driver of this gender difference.

Conclusion

The well-known gender bias in the treatment of CVD also appears to take place in the primary prevention of CVD with statin therapy. These findings have highlighted the gender bias in primary prevention of CVD, supporting the scarce existing literature on this topic and providing more recent evidence in line with the updated CVD prevention guidance. This has implications in developing interventions based in the health system and community context to improve the treatment and survival outcomes for women with CVD.

[Clinicopathological features of mature T/NK cell lymphoma with aberrant CD20 or CD79α expression]

Objective: To investigate the clinicopathological characteristics and prognosis of mature T/NK cell lymphomas with aberrant CD20 or CD79α expression. Methods: A retrospective analysis of 641 cases of mature T/NK cell lymphoma diagnosed from January 2014 to December 2020 was performed, and 14 cases of CD20-positive and one case of CD79α-positive mature T/NK-cell lymphoma were identified. Histological examination, immunohistochemical characterization, in situ hybridization for Epstein-Barr virus encoded early RNA (EBER), and PCR testing for immunoglobulin and T cell receptor (TCR) gene rearrangements were performed. Clinicopathological characteristics of these lymphomas were analyzed. Results: There were 13 males and 2 females, with a median age of 56 years. There were 8 cases of peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), 3 cases of extranodal NK/T-cell lymphoma, nasal type (ENKTCL), 2 cases of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) and 2 cases of angioimmunoblastic T-cell lymphoma (AITL). Twelve cases were stage Ⅲ or Ⅳ lymphomas. The prognosis was overall poor. The histology, immunophenotype and TCR gene rearrangement were not significantly different from the corresponding types of lymphoma. Ki-67 proliferation index was over 70% in all cases. The expression of CD20 or CD79α was weak and heterogeneous. All 15 case of Ig gene rearrangement were polyclonal. Conclusions: Mature T/NK cell lymphoma with abnormal expression of CD20 or CD79α is rare, commonly found in advanced stage, and associated with poor prognosis. The expression of CD20 or CD79α in these cases is weaker than the corresponding mature T/NK cell lymphomas, while its proliferation index is higher. Histomorphology, extensive immunoprofiling and molecular detection are required for accurate diagnosis.

[Pollution characteristics, source analysis, and risk assessment of metal and metalloid in PM2.5 of Shijiazhuang city]

In 2020, the mass concentration of PM_2.5 in Shijiazhuang urban area was(80.30±71.43)μg/m³. The Spearman correlation analysis between metals and metalloids showed that Sb with Cd, Pb, Ni, Se, Cd with Pb, Ni, Se, Pb with Ni, Se, Ni with Se, and Se with Tl were positively correlated, with a coefficient greater than 0.5. The main sources of metals and metalloids of PM_2.5 were traffic emissions, fuel combustion, metal smelting and dust. The HQ values of Pb, Hg and Mn for each population were less than 1, with lower non-carcinogenic risk. The R values of carcinogenic risk of Ni and Cd in each population were less than 1×10^-6, which could be acceptable risk level for the population. The R values of carcinogenic risk of As and Cr in different populations were between 1×10^-6 and 1×10^-4, with potential carcinogenic risk, particularly higher in adult males.

Myocardial deformation assessed by CMR in children after multisystem inflammatory syndrome (MIS-C)

BACKGROUND

Short-term sequelae of Multisystem Inflammatory Syndrome in Children (MIS-C), recently published by our institution, showed rapid improvement of the cardiac abnormalities within a few weeks after the onset of the disease. However, subtle residual abnormalities, affecting mainly the myocardial interstitium, were shown in some of the patients. The current study aimed to assess myocardial deformation with CMR shortly after MIS-C.

METHODS

Sixty children were included into the study; 30 following MIS-C (onset-to-scan mean 27 days, SD 11) and 30 controls. Strain values were compared between patients and controls and additionally to published paediatric normal CMR values. U-Mann Whitney test was used for comparison of the myocardial deformation between patients and controls.

RESULTS

Median age of the patients was 9.0 years (range 0.99-14.4) and controls 9.8 years (range 4.7-14.9). All conventional CMR parameters in patients were in normal range. Strain values were significantly lower in patients than in controls. When compared to published centile graphs, radial and circumferential global strain was within 2.5th and 97.5th centile in all patients. Eleven patients had global longitudinal strain between 2.5th centile and 50th centile, 1 patient was below 2.5th centile and all the others above 50th centile. Only 3 controls had global longitudinal strain between 2.5th centile and 50th centile, all other had higher strain.

CONCLUSIONS

This study demonstrates that myocardial deformation indices measured by CMR are within normal range in the vast majority of the patients within a few weeks after the onset of MIS-C. However, when compared to healthy controls, all strain parameters were lower in patients.

Imaging Features of Symptomatic MCA Stenosis in Patients of Different Ages: A Vessel Wall MR Imaging Study

BACKGROUND AND PURPOSE

The prevalence of intracranial artery stenosis is high in Asian people. This study aimed to investigate whether there are differences in the imaging features of symptomatic MCA stenosis in patients of different ages using vessel wall MR imaging.

MATERIALS AND METHODS

We retrospectively reviewed the data of consecutive patients with unilateral MCA stenosis based on a prospectively established vessel wall MR imaging data base between January 2017 and December 2018. According to age, the patients were divided into the young group (18-45 years of age) and the middle-aged and elderly group (older than 45 years of age).

RESULTS

Overall, 131 patients with unilateral MCA stenosis were included (45.8% in the young group and 54.2% in the middle-aged and elderly group). Middle-aged and elderly patients had a higher prevalence of hypertension (P = .01) and diabetes (P = .05). The lesion length (P < .0001), proportion of circular involvement (P = .006), and proportion of circular enhancement (P = .03) were higher in the young group than in the middle-aged and elderly group. The analysis of the atherosclerotic subgroup showed that compared with middle-aged and elderly patients, young patients had longer lesions (P = .002). The atherosclerotic-versus-nonatherosclerotic subgroup analysis showed that the maximal wall thickness in the patients with atherosclerosis was larger than that of patients without it (P = .002).

CONCLUSIONS

Compared with the middle-aged and elderly group, young patients with MCA stenosis tended to have longer lesions and more circular wall involvement and circular enhancement, which may indicate the differences in underlying vascular pathophysiologic and developmental mechanisms in symptomatic MCA stenosis.

Prediction of endogenous thrombolytic activity in patients with coronary artery disease

Background

Endogenous thrombolytic activity (ETA) has been suggested as an essential factor related to the acute coronary syndrome. However, there have been little data regarding clinical characteristics of ETA in East Asians.

Method

As an interim study of the entire cohort (n=2,000), we analyzed a total of 278 patients who underwent percutaneous coronary intervention (PCI) due to coronary artery disease (CAD). Informed consent was obtained from all research subjects. Blood samples of patients were brought before the procedure. The Global Thrombosis Test (GTT, Thromboquest, UK), a novel test for examining ETA, was used. Lysis time (LT), which means the time interval between blood flow occlusion and restart, was used as an indicator for ETA. Clinical, laboratory and angiographic characteristics were obtained. LT=3000 seconds was used as a cut-off value to divide patients into two groups. P value&lt;0.05 was regarded as significant.

Results

LT of Korean CAD patients showed bimodal distribution. Median value was 1695 [IQR: 1099, 5932] and it was higher than previous data from Europeans (Figure 1). Patients with impaired ETA (LT&gt;3000) were older and more diabetic. They showed higher creatinine, aPTT, fibrinogen, D-dimer, c-reactive protein, and proBNP values. Moreover, they had lower hemoglobin and platelet levels. Intracoronary thrombus was more frequently observed in LT&gt;3000 group. In the multivariable regression analysis, hemoglobin (per g/dL, odds ratio 0.766, 95% confidence interval (CI) 0.632–0.928) and fibrinogen level(per 10mg/L, odds ratio 1.054, 95% CI 1.015–1.095) could significantly predict impaired ETA.

Conclusion

East Asian patients showed a right-shifted distribution of ETA compared to that of Europeans. Patients with impaired ETA had different clinical, laboratory and angiographic characteristics from those with intact ETA. Hemoglobin and fibrinogen level were significantly associated with impaired ETA. Further studies are warranted to confirm causal relationship among these factors.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Research Foundation, Republic of Korea

A genome-wide association study reveals additive and dominance effects on growth and fatness traits in large white pigs

The dominance effect is a kind of non-additive effect due to the interaction between alleles at the same locus. Quantitative traits such as growth traits in farm animals have been found to be influenced by dominance effects. However, dominance effects are usually ignored in the genome-wide association study (GWAS) of complex traits for farm animals. In this study, we performed GWAS and genetic parameters estimation for the two traits age at 100 kg (AGE) and backfat thickness at 100 kg (BF) of 3572 Large White pigs. The pigs were from three breeding farms of China and were genotyped by an in-house designed 50k SNP chip. Our results showed significant non-zero variance for the dominance effect of AGE, while the dominance effect of BF was not significant. Using a GWAS model accounting for both additive and dominance effects, we identified three additive and two dominance significant SNPs for the trait AGE. For the trait BF, three genome-wide significant additive SNPs were detected, but no significant SNP was found for the dominance effect. In total, six important functional genes (NPAS3, USP16, PARN, ARL15, GPC3, ABHD4) near significant SNPs were identified as candidate genes associated with AGE or BF. Notably, ARL15 and PARN were associated with AGE near the dominance association signals. Overall, the newly detected SNPs and newly identified candidate genes in our study added new information about the genetic architectures of growth and fatness traits in pigs, and have the potential to be applied to the pig breeding program in the future.

High-Order Phase-Dependent Asymmetry in the Above-Threshold Ionization Plateau

Above-threshold ionization spectra from cesium are measured as a function of the carrier-envelope phase (CEP) using laser pulses centered at 3.1  μm wavelength. The directional asymmetry in the energy spectra of backscattered electrons oscillates three times, rather than once, as the CEP is changed from 0 to 2π. Using the improved strong-field approximation, we show that the unusual behavior arises from the interference of few quantum orbits. We discuss the conditions for observing the high-order CEP dependence, and draw an analogy with time-domain holography with electron wave packets.

Auditory cortex hyperconnectivity before rTMS is correlated with tinnitus improvement

INTRODUCTION

Repetitive transcranial magnetic stimulation (rTMS) has been used as a potential treatment for tinnitus; however, its effectiveness is variable and unpredictable. We hypothesized that resting-state functional connectivity before rTMS may be correlated with rTMS treatment effectiveness.

METHODS

We applied 1-Hz rTMS to the left primary auditory (A1) and dorsolateral prefrontal cortices (DLPFC) of 10 individuals with tinnitus and 10 age-matched controls. Resting-state functional magnetic resonance imaging (fMRI) studies were performed approximately one week before rTMS. Seed-based connectivity analyses were conducted for each individual, with seed regions as rTMS target areas.

RESULTS

Compared to controls, the left superior temporal areas showed significantly increased positive connectivity with the left A1 and negative connectivity with the left DLPFC in the tinnitus group. The left frontoparietal and right cerebellar areas showed significantly increased negative connectivity with the left A1 and positive connectivity with the left DLPFC. Seed-based hyperconnectivity was correlated with tinnitus improvement (pre-rTMS vs. 2-week post-rTMS Tinnitus Handicap Inventory scores). Tinnitus improvement was significantly correlated with left A1 hyperconnectivity; however, no correlation was observed with left DLPFC connectivity. Positive rTMS outcomes were associated with significantly increased positive connectivity in bilateral superior temporal areas and significantly increased negative connectivity in bilateral frontal areas.

CONCLUSIONS

Our results suggest that oversynchronisation of left A1 connectivity before rTMS of the left A1 and DLPFC is associated with treatment effectiveness.

Segmental and global longitudinal strain differences between children with paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 pandemic and Kawasaki disease

Funding Acknowledgements

Type of funding sources: None.

Introduction

 The paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) and Kawasaki disease (KD) have overlapping features. This study aimed to describe the strain segmental analysis among both entities.

Methods

Retrospective review of strain segmental analysis within 4 weeks of presentation of symptoms among children diagnosed with PIMS-TS between April and June 2020 and a historic cohort of typical KD from the Royal Brompton Hospital, London.

Results

We included 33 PIMS-TS patients (23 males, 69.7%) at a mean age of 8 ± 4,9 years old and 45 KD patients (31 males, 68,9%) at a mean age of 5,8 ± 4,5 years old. PIMS-TS patients were older at presentation (p = 0.038). Left ventricle ejection fraction (LVEF) was normal in both groups (63,3% vs 63,5%; p= 0,89), 4/33 PIMS-TS children (12,1%) had coronary arteries abnormalities (CAA), whereas 100% of KD cohort had CAA. Both groups had a normal global longitudinal strain (GLS),but in PIMS-TS it was significantly reduced compared to the KD group (-20% vs -22%; p = 0,008). Basal segments were the most affected in PIMS-TS with significant difference in the basal anterior and anterolateral strain compared to KD (respectively -18,2% vs -23,4%; p < 0,001 and - 16,7% vs -22,7%; p < 0,001). PIMS-TS had a greater anterior, anterolateral and posterior segments involvement with a significant reduction in the anterolateral mid-wall longitudinal strain (-18,3% vs -22%; p = 0,002). Apical segments were less involved, with significant difference only in the septal and inferior apical strain (respectively p = 0.001 and p = 0,032).

Conclusions

 These preliminary data showed that after 4 weeks from the onset of symptoms, all PIMS-TS patients had a normal LVEF but they had a significant reduction in GLS and different segmental involvement compared to KD cohort. We hypothesize that these findings may be related to direct myocardial damage in PIMS-TS rather than caused by coronaries perfusion abnormalities.

Clinical Characteristics and Short-Term Outcomes of Acute Kidney Injury Missed Diagnosis in Older Patients with Severe COVID-19 in Intensive Care Unit

OBJECTIVES

Patients with severe or critical COVID-19 are at higher risk for developing acute kidney injury (AKI). However, whether AKI is diagnosed in all the patients and the correlation between the outcomes of COVID-19 are not well understood.

PATIENTS AND METHODS

This cohort study was conducted from February 4, 2020 to April 16, 2020 in Wuhan, China. All consecutive inpatients with laboratory-confirmed COVID-19 were included in this study. AKI was defined according to the KDIGO 2012 criteria. The outcomes of patients with and without AKI and whether AKI was or was not recognized were compared.

RESULTS

A total of 107 elderly patients were included in the final analysis. The median age was 70 (64-78) years, and 69 (64.5%) were men. Overall, 48 of 107 patients (44.9%) developed AKI during hospitalization. Meanwhile, 22 (45.8%) cases with AKI was not recognized (missed diagnosis) in this cohort. The Kaplan-Meier curves showed that survival was better in the non-AKI group than in the AKI group (log-rank, all P < 0.001); in the subgroups of the patients with AKI, the hospital survival rate decreased when AKI was not recognized. The survival of patients with recognized AKI was better than that of patients with unrecognized AKI (log-rank, all P < 0.001). According to the multivariate regression analysis, the independent risk factors for in-hospital mortality were AKI (recognized AKI vs non-AKI: HR = 2.413; 95% CI = 1.092-5.333; P = 0.030 and unrecognized AKI vs non-AKI: HR = 4.590; 95% CI = 2.070-10.175; P <0.001), C-reactive protein level (HR = 1.004; 95% CI = 1.000-1.008; P = 0.030), lactate level (HR = 1.236; 95% CI = 1.098-1.391; P < 0.001), and disease classification (critical vs severe: HR = 0.019; 95% CI = 1.347-26.396; P = 5.963).

CONCLUSIONS

AKI is not an uncommon complication in elderly patients with COVID-19 who admitted to ICU. Extremely high rates of underdiagnosis and undertreatment of AKI have resulted in an elevated in-hospital mortality rate. Kidney protection is an important issue that cannot be ignored, and intensive care kidney specialists should take responsibility for leading the battle against AKI.

0840 Sleep Quality in Clinically Indicated In-Laboratory Polysomnography

Introduction

Few studies have explored how patients sleep or what characteristics might be predictive of poor sleep during clinically-indicated polysomnography (PSG) in an in-laboratory setting.

Methods

We reviewed clinically indicated diagnostic PSG studies completed over a 10-year period in a single academic sleep center. Total sleep time (TST) and sleep efficiency (SE) were used as proxies for sleep quality. Patients were categorized as normal or poor sleepers based on TST &lt;4 hours or SE &lt;50%. Multivariate linear and logistic regression analyses were performed to determine factors associated with sleep quality while controlling for demographics, medications, comorbidities and measures of sleep.

Results

We included 4957 patients, who were mostly female (58.9%), middle-aged (52.9 y), Caucasian (69.3%), and overweight or obese (91.3%). 3682 patients (74.2%) were diagnosed with sleep apnea (Apnea Hypopnea Index(AHI)&gt;5/hr).

Average TST was 5.75±1.43 hours (Interquartile range [IQR] = 4.94 - 6.73) and average SE was 75.1%±16.1% (IQR=66.9 - 87.2). TST and SE were lower for males compared to females (5.48 vs 5.93 hr, p&lt;0.001; 73% vs 77%, p&lt;0.001). In multivariable analysis, older age (TST: OR = 1.04, 95% CI:[1.03,1.05]; SE: OR = 1.04, 95% CI:[1.04,1.05]), male sex (TST: 1.38,[1.14,1.68]; SE: 1.34,[1.07,1.68]), normal body habitus (TST: 1.47,[1.02,2.08]; SE: 1.51,[1.01,2.27]) and a higher AHI (TST: 1.02,[1.02,1.03]; SE: 1.02,[1.003,1.03]) were significantly associated with being a poor sleeper for both TST and SE. Antidepressant use was associated with poor sleep for TST (0.77, [0.59,1]), but not for SE (0.98, [0.73,1.3]).

Conclusion

Sleep quality during the in-laboratory PSG differed by sex, age and presence of sleep apnea. Sleep quality during in-lab PSG is thought to be compromised by obtrusive monitoring and an unfamiliar environment, but average sleep quality may be higher than expected for patients in the laboratory. Future studies should consider examining in-lab sleep quality in different patient populations.

Support

N/A

[Relationship between serum brain-derived neurotrophic factor and clinical stage and dysmenorrhoea of enodmetriosis]

Objective: To explore the association between serum brain-derived neurotrophic factor and clinical stage and dysmenorrhoea of endometriosis. Methods: A total of 82 patients were studied with laparoscopically diagnosed endometriosis between June 2017 and June 2019, and 75 healthy women with reproductive age were selected as the control group during the same period. The endometriosis patients were scored by visual analogue scale(VAS)according to their preoperative dysmenorrhoea.And endometriosis was staged and scored according to the score of Revised American Fertility Society(r-AFS).Enzyme-linked immunosorbent assay (ELISA) was used to determine preoperative BDNF level in serum, and the correlation between BDNF level with clinical stage as well as dysmenorrhea of endometriosis were analysed. Results: The serum BDNF level in endometriosis patients was (1 082±43) ng/L, significantly higher than that in the normal control [(649±30) ng/L], there was statistical difference between the two groups(P<0.001). The BDNF expression in patients with r-AFS stage Ⅲ-Ⅳ was higher than that in patients with Ⅰ-Ⅱ stage [(1 164±389) ng/L vs (791±218)ng/L, P<0.001]. BDNF level in serum was closely correlated with the degree of dysmenorrhea (r=0.682), and the BDNF level in patients with moderate or severe dysmenorrhea was significantly higher than that in patients without dysmenorrhea and patients with mild dysmenorrhea [(1 292±43) ng/L vs(718±36) ng/L, P<0.001]. Conclusions: The serum BDNF level in endometriosis patients is positively correlated with clinical stage and dysmenorrhea.