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Skeletal muscle is a highly dynamic and malleable tissue that is able to adapt to different stimuli placed upon it, both during gestation and after birth, ultimately resulting in anatomical changes to muscle fibre composition. Variation in nutrient supply throughout gestation is common, whether in livestock or in the human. The specific effects of maternal nutrition on foetal development are at the forefront of scientific research. However, results describing how different maternal feeding strategies affect skeletal muscle fibre development in the offspring are not fully consistent, even where the same time windows during gestation have been examined. The aim of this study is to determine the effects of increased maternal nutrition (above the recommended levels) on the Musculus semitendinosus phenotype of progeny. In all, 24 pregnant sows were assigned to one of four feeding regimes during gestation; T1 (control group): 30 MJ digestible energy per day (MJ DE/day) throughout gestation, T2: same as that for T1 but increased to 60 MJ DE/day from 25 to 50 days of gestation (dg), T3: same as that for T1 but increased to 60 MJ DE/day from 50 to 80 dg, T4: same as that for T1 but increased nutrition to 60 MJ DE/day from 25 to 80 dg. Light-and heavy-weight littermate pairs of the same sex were selected at birth and individually fed to slaughter (c. 158 days). Histochemical and immunohistochemical staining were used to identify the predominantly oxidative (deep) and less oxidative (superficial) regions of the M. semitendinosus, and to determine total fibre number and proportions of fibre types. The results demonstrate that increased maternal nutrition alters skeletal muscle phenotype in the offspring by changing fibre-type proportions, leading to an increased oxidative capacity due to an increase in Type IIA fibres. No change in total muscle area, total muscle fibre number, or fibre cross-sectional area is observed. The precise molecular mechanism(s) by which these findings occur is being investigated.

After slaughter of pigs, the pH of the meat decreases due to lactate accumulation within the tissue. In addition to calcium homeostasis, energy metabolism plays a key role during the muscle-to-meat transition, and it is interesting to know how specific enzymes of the glycolytic and oxidative pathways change during this process, especially in relation to the antemortem situation, and if there is an impact of these alterations on the meat quality characteristics. Therefore, in the present study samples of the LM from the pig genetic groups Pietrain (Pi), Duroc (Du), and a Du × Pi crossbreed population (DuPi) were collected 24 h before as well as 1 min, 40 min, and 12 h after slaughter, and the activities of the glycogen phosphorylase (GP), phosphofructokinase (PFK), lactate dehydrogenase (LDH), citrate synthase (CS), NADH-ubiquinone oxidoreductase (complex I), and cytochrome oxidase were analyzed. Additional investigations include carcass and meat quality characteristics as well as the microstructure of the LM. The Pi breed had greater (P< 0.05) carcass yield and lean meat values, but no differences (P > 0.05) of the meat quality traits could be determined between the investigated pig breeds. The Pi pigs exhibited a greater (P < 0.05) percentage of fast-twitch glycolytic and had smaller amounts (P < 0.05) of slow-twitch-oxidative fibers in comparison with the Du pigs. The enzyme activities of the GP, PFK, and complex I increased (P < 0.05) immediately after slaughter (1 min postmortem) of the pigs and the activity of the LDH within 40 min postmortem. After 12 h, the GP, PFK, LDH, and complex I activities decreased to the amount of the preslaughter sample. No differences could be found with regard to the enzyme activities of the CS and cytochrome oxidase at all determination times. Considering the enzyme activities within the different breeds, the Pi pigs exhibited greater (P < 0.05) GP and PFK and the Du animals exhibited greater (P < 0.05) CS and complex I activities. The study indicates that the glycolytic enzymes GP, PFK, and LDH as well as the complex I influence the muscle-to-meat transition process after slaughter of the animals without an impact on the muscle quality. The activities of the GP, PFK, CS, and complex I reflect the differences of the muscle fiber composition between the Pi and Du pigs.

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Background: Palliative radiotherapy (RT) is effective, but some patients die during treatment or too soon afterward to experience benefit. This study investigates end-of-life RT patterns to inform shared decision-making and facilitate treatment consistent with palliative goals. Materials and Methods: All patients who died ≤6 months after initiating palliative RT at an academic cancer center between 2015 and 2018 were identified. Associations with time-to-death, early mortality (≤30 days), and midtreatment mortality were analyzed. Results: In total, 1,620 patients died ≤6 months from palliative RT initiation, including 574 (34%) deaths at ≤30 days and 222 (14%) midtreatment. Median survival was 43 days from RT start (95% CI, 41–45) and varied by site (P<.001), ranging from 36 (head and neck) to 53 days (dermal/soft tissue). On multivariable analysis, earlier time-to-death was associated with osseous (hazard ratio [HR], 1.33; P<.001) and head and neck (HR, 1.45; P<.001) sites, multiple RT courses ≤6 months (HR, 1.65; P<.001), and multisite treatments (HR, 1.40; P=.008), whereas stereotactic technique (HR, 0.77; P<.001) and more recent treatment year (HR, 0.82; P<.001) were associated with longer survival. No difference in time to death was noted among patients prescribed conventional RT in 1 to 10 versus >10 fractions (median, 40 vs 47 days; P=.272), although the latter entailed longer courses. The 30-day mortality group included 335 (58%) inpatients, who were 27% more likely to die midtreatment (P=.031). On multivariable analysis, midtreatment mortality among these inpatients was associated with thoracic (odds ratio [OR], 2.95; P=.002) and central nervous system (CNS; OR, 2.44; P=.002) indications, >5-fraction courses (OR, 3.27; P<.001), and performance status of 3 to 4 (OR, 1.63; P=.050). Conversely, palliative/supportive care consultation was associated with decreased midtreatment mortality (OR, 0.60; P=.045). Conclusions: Earlier referrals and hypofractionated courses (≤5–10 treatments) should be routinely considered for palliative RT indications, given the short life expectancies of patients at this stage in their disease course. Providers should exercise caution for emergent thoracic and CNS indications among inpatients with poor prognoses due to high midtreatment mortality.

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received molecular targeted therapy, there were in 3 (1.6%), 3 (1.6%), 4 (2.2%), 2 (1.1%), 3 (1.6%), 0 and 2 (1.1%) patients, respectively. Use of molecular targeted agents and use of VEGFIs showed no significant difference in occurrence of G3 toxicities (3.8% vs 3.7%, pZ1.0, and 7.2% vs 2.8%, pZ0.095). History of previous abdominopelvic surgery (6.9% vs 1.6%, pZ0.009) was only a significant factor. Among patients with molecular targeted agents use, G3 toxicities in patients with VEGFIs use were significantly more than those in patients with other agents use (7.2% vs 1.0%, pZ0.046). Moreover, among patients with VEGFIs use, G3 toxicities in patients with VEGFIs use concurrently or during 7 days before and after RT were significantly more than those in patients with VEGFIs use during other period (18.2% vs 3.3%, pZ0.04). Conclusion: Previous abdominopelvic surgery showed significantly higher occurrence rate of severe GI toxicities. Combination of RT with VEGFIs was significantly riskier than with the other agents. Use of VEGFIs concurrently or during 7 days before and after RT seems to be avoided.

235 Background: Quality and safety reporting is one of the most important aspects of creating a culture of safety. As part of a multidisciplinary Cancer Network, the Radiation Oncology Division at the lead institution devised an electronic incident reporting system that was implemented at the Network partners to define, standardize, quantify, and trend incidents in the radiation oncology treatment and care process. The purpose of this study is to assess robustness of the system, initial trends seen, and potential to improve quality and safety of the Network practice. Methods: Beginning in January 2017, the incident reporting system at the lead institution was configured to provide inclusion of 13 partnering radiation oncology facilities. Over one year, the organizations were on-boarded and trained on the use of the application. Descriptive analyses of the data from the use of this new reporting system were used in this study. Results: From January 1, 2017 to April 30 2018, a total of 832 incident reports were submitted by 13 different facilities. The average number of days from event submission to resolution was reduced to 10.25 days, compared with up to 60 days before implementation of the new central reporting system. The change in reporting rate was variable across the partner sites following implementation of the new system. The most frequent event types reported included ineffective communication (13%), planning-related problems (5%), incomplete or missing simulation orders (5%), and scheduling error or conflict (4%). Conclusions: Implementation of a centralized reporting system across a network of partner sites has greatly improved the overall reporting process, with reduced event resolution time and increased capability of tracking and trending incidents. By standardizing incident reporting across institutions, there are multiple opportunities to augment a strong culture of safety.