Surgical management of severe planovalgus foot deformity in children with generalised joint hypermobility.

BACKGROUND: This study aimed to evaluate the outcomes of calcaneal lengthening osteotomy (CLO) and double arthrodesis of the talonavicular and calcaneocuboid joints (DA) for correcting planovalgus foot deformity exclusively in patients with generalised joint hypermobility. METHODS: We retrospectively reviewed 29 feet in 17 consecutive patients who underwent either CLO or DA. The mean age at surgery was 11.3 ± 2.3 years, and the mean follow-up duration was 7.7 ± 3.2 years. Preoperative and final follow-up radiographs and dynamic foot-pressure measurements were analysed. RESULTS: Both operations significantly improved the radiographic parameters, except for the lateral talocalcaneal angle in the CLO group. Pedobarographic study demonstrated an elevation of the medial longitudinal arch and an improved foot-pressure distribution after both surgeries. The plantar pressure in the lateral forefoot significantly increased only in the DA group, while the pressures exerted on the medial forefoot and hindfoot and the arch index improved only in the CLO group. CONCLUSIONS: Both CLO and DA effectively improve the foot alignments of the deformity in patients with generalised joint hypermobility. However, differences were observed in the changes in the lateral talocalcaneal angle and plantar pressure distribution between the two procedures. LEVEL OF EVIDENCE: Therapeutic Level III.

Synergistic Enhancement of Electron Dynamics and Optical Properties in Zeolitic Imidazolate Framework-8-Derived Zinc Oxide via Surface Plasmon Resonance Effects of Silver Nanoparticles under UV Irradiation.

This study investigates the surface plasmon resonance (SPR)-induced UV photoresponse of zinc oxide (ZnO) derived from zeolitic imidazolate framework-8 (ZIF-8) to assess the influence of silver nanoparticles (Ag NPs) on the photoresponse behavior of metal-organic framework (MOF)-derived ZnO. The initial synthesis involved a thermal treatment in air to convert ZIF-8 into ZnO. We noted enhanced optical absorption both in the UV and visible spectra with the deposition of Ag NPs onto the ZIF-8-derived ZnO. Additionally, the presence of Ag NPs in the ZnO resulted in a substantial increase in current, even without any light exposure. This increase is attributed to the transfer of electrons from the Ag NPs to the ZnO. Photocurrent measurements under UV illumination revealed that the photocurrent with Ag NPs was significantly higher-by two orders of magnitude-compared with that without Ag NPs. This demonstrates that SPR-induced absorption markedly boosted the photocurrent, although the current rise and decay time constants remained comparable to those observed with ZnO alone. Although Ag NPs contribute electrons to ZnO, creating a "pre-doping" effect that heightens baseline conductivity (even in the absence of light), this does not necessarily alter the recombination dynamics of the photogenerated carriers, as indicated by the similar rise and decay time constants. The electron transfer from Ag to ZnO increases the density of charge carriers but does not significantly influence their recombination.

Inducing and Understanding Pseudocapacitive Behavior in an Electrophoretically Deposited Lithium Iron Phosphate Li-Metal Battery as an Electrochemical Test Platform.

Our study has effectively employed electrophoretic deposition (EPD) using AC voltage to develop a lithium iron phosphate (LFP) Li-ion battery featuring pseudocapacitive properties and improved high C-rate performance. This method has significantly improved the battery's specific capacity, achieving an impressive 100 mAhg-1 at a 5 C discharge rate, which showcases its superior high-rate capability. Additionally, the battery displayed excellent reversibility during its performance cycles. These results confirm the EPD method's efficacy in improving LFP electrode performance, yielding notable improvements in cycling stability and high-rate capability. The enhanced capacity and high-rate performance of the electrophoretic-deposited LFP electrodes are largely due to the fast kinetics facilitated by pseudocapacitive behavior-induced charge storage and a high Li-ion diffusion constant measured in our EPD-deposited LFP electrodes. This underscores the practicality of our approach and the development of a fundamental test platform to investigate the pseudocapacitive charge storage mechanism in electrodes with typical battery-like behavior.

Potential of cannabidiol as acne and acne scar treatment: novel insights into molecular pathways of pathophysiological factors.

Cannabidiol (CBD), which is derived from hemp, is gaining recognition because of its anti-inflammatory and lipid-modulating properties that could be utilized to treat acne. We conducted experiments to quantitatively assess the effects of CBD on acne-related cellular pathways. SEB-1 sebocytes and HaCaT keratinocytes were exposed to various CBD concentrations. CBD exhibited a concentration-dependent impact on cell viability and notably reduced SEB-1 viability; furthermore, it induced apoptosis and a significant increase in the apoptotic area at higher concentrations. Additionally, CBD remarkably reduced pro-inflammatory cytokines, including CXCL8, IL-1α, and IL-1ß. Additionally, it inhibited lipid synthesis by modulating the AMPK-SREBP-1 pathway and effectively reduced hyperkeratinization-related protein keratin 16. Simultaneously, CBD stimulated the synthesis of elastin, collagen 1, and collagen 3. These findings emphasize the potential of CBD for the management of acne because of its anti-inflammatory, apoptotic, and lipid-inhibitory effects. Notably, the modulation of the Akt/AMPK-SREBP-1 pathway revealed a novel and promising mechanism that could address the pathogenesis of acne.

Association of Higher Hemoglobin Level With Significant Carotid Artery Plaque in the General Population.

Objective: Serum hemoglobin (Hb) level affects the viscosity of blood. Several studies have reported that Hb level is associated with adverse cardiovascular outcome. However, there is a paucity of evidence on the association between serum Hb level and the risk of subclinical atherosclerosis. Thus, the objective of this study was to investigate the relationship between Hb level and risk of carotid plaque in a health checkup cohort. Methods: This retrospective study analyzed a total of 3,805 individuals without history of cardiovascular disease (CVD) who underwent carotid ultrasonography (USG) between January 2016 and June 2018. Participants were divided into 4 groups based on Hb quartiles in each of male and female. Carotid plaque score was calculated based on USG reports. Multivariable logistic regression analysis was performed for each index of quartile groups regarding the risk of carotid plaque. Results: Of 3,805 individuals (mean age, 52.62±10.25 years; 2,674 [70.28%] males), mean Hb level was 15.11±0.75 g/dL in male and 13.35±0.74 g/dL in female. When the Q1 group was compared to the Q4, increasing quartile of Hb was associated with the presence of significant carotid plaque (plaque score ≥3) in male (adjusted odds ratio [OR], 1.538; 95% confidence interval [CI], 1.182-2.001; p=0.001) and female (adjusted OR, 1.749; 95% CI, 1.058-2.676; p=0.01). Conclusion: A high Hb level is associated with an increased risk of carotid plaques in individuals without history of CVD. This finding may support the need for early screening of CVD in individuals with high Hb levels.

Approach to postpancreatectomy care Impacts outcomes: Retrospective Validation of the PORSCH trial.

BACKGROUND: In the recent PORSCH trial, a three-part postpancreatectomy care algorithm was employed with a near 50 â€‹% reduction in mortality. We hypothesized that clinical care congruent with this protocol would correlate with better outcomes in our patients. METHODS: Real-world postoperative care was compared to the pathway described by the PORSCH trial and patients were assigned into groups based on congruence with its recommendations. The primary composite outcome (PCO) consisted of 90-day mortality, organ failure, and interventions for bleeding. RESULTS: Of 289 patients, care of 12 â€‹% was entirely congruent with the PORSCH algorithm. The PCO was recorded in 9 â€‹% of the PORSCH care group, 8 â€‹% of the Partial-PORSCH care group, and 19 â€‹% of the Non-PORSCH care group (p â€‹= â€‹0.044). Adverse outcomes were highest when pancreaticoduodenectomy patients received care incongruent with the algorithm's CT imaging recommendations. CONCLUSIONS: These results add external validity to the principles of clinical care underlying the PORSCH algorithm.

Optimizing Embryo Collection for Application of CRISPR/Cas9 System and Generation of Fukutin Knockout Rat Using This Method.

Rat animal models are widely used owing to their relatively superior cognitive abilities and higher similarity compared with mouse models to human physiological characteristics. However, their use is limited because of difficulties in establishing embryonic stem cells and performing genetic modifications, and insufficient embryological research. In this study, we established optimal superovulation and fertilized-egg transfer conditions, including optimal hormone injection concentration (≥150 IU/kg of PMSG and hCG) and culture medium (mR1ECM), to obtain high-quality zygotes and establish in vitro fertilization conditions for rats. Next, sgRNA with optimal targeting activity was selected by performing PCR analysis and the T7E1 assay, and the CRISPR/Cas9 system was used to construct a rat model for muscular dystrophy by inducing a deficiency in the fukutin gene without any off-target effect detected. The production of fukutin knockout rats was phenotypically confirmed by observing a drop-in body weight to one-third of that of the control group. In summary, we succeeded in constructing the first muscular dystrophy disease rat model using the CRISPR/CAS9 system for increasing future prospects of producing various animal disease models and encouraging disease research using rats.

Soluble expression of recombinant coagulation factor IX protein using Escherichia coli.

Hemophilia B is a congenital bleeding disorder caused by factor IX (FIX) deficiency. Generation of recombinant FIX (rFIX) is required for detecting a Hemophilia B indicator, anti-FIX antibody. In this study, we described a method for producing recombinant FIX (rFIX) using Escherichia coli. We constructed a FIX-expressing plasmid without a fusion tag protein-encoding gene and produced rFIX as a soluble form within five days. Dose-dependent curve was obtained from ELISA using anti-FIX antibody, indicating that the rFIX can be used as an antigen to detect anti-FIX antibody with high affinity and sensitivity.

Efficient Model-Based Anthropometry under Clothing Using Low-Cost Depth Sensors.

Measuring human body dimensions is critical for many engineering and product design domains. Nonetheless, acquiring body dimension data for populations using typical anthropometric methods poses challenges due to the time-consuming nature of manual methods. The measurement process for three-dimensional (3D) whole-body scanning can be much faster, but 3D scanning typically requires subjects to change into tight-fitting clothing, which increases time and cost and introduces privacy concerns. To address these and other issues in current anthropometry techniques, a measurement system was developed based on portable, low-cost depth cameras. Point-cloud data from the sensors are fit using a model-based method, Inscribed Fitting, which finds the most likely body shape in the statistical body shape space and providing accurate estimates of body characteristics. To evaluate the system, 144 young adults were measured manually and with two levels of military ensembles using the system. The results showed that the prediction accuracy for the clothed scans remained at a similar level to the accuracy for the minimally clad scans. This approach will enable rapid measurement of clothed populations with reduced time compared to manual and typical scan-based methods.

Mimickers of immunoglobulin G4-related hepatobiliary disease on biopsy.

With the growing recognition of IgG4-related hepatobiliary disease, establishing a definitive diagnosis relies mainly on a combination of clinical findings, serological markers, and imaging modalities. However, the role of histopathological evaluation remains indispensable, particularly in cases necessitating differential diagnosis or malignancy exclusion. While diagnosing IgG4-related hepatobiliary disease through surgical resection specimens is often straightforward, pathologists encounter substantial challenges when evaluating biopsies. The increasing rarity of surgical interventions exacerbates this due to improved disease recognition and suspicion. Numerous confounding factors, including the absence of the characteristic histologic features, limited tissue sample size, biopsy artifacts, and the limited value of IgG4 counts, further complicate the diagnostic process. Additionally, many other disorders exhibit clinical and histological features that overlap with IgG4-related disease, intensifying the complexity of interpreting biopsy specimens. This article explores the clinical and histomorphologic features of IgG4-related hepatobiliary disease and its potential mimickers. It offers valuable insights for pathologists and clinicians when confronted with biopsy specimens from hepatobiliary organs.

Effect of Solitary Osteochondroma on Alignment and Length in the Lower Extremities.

BACKGROUND: There is a lack of information about the effects of untreated solitary osteochondroma (SO) on longitudinal growth of the lower extremities in children and adolescents. This study aimed to assess the coronal alignment and length of the lower extremity in patients with SO around the knee and to identify the factors related to the development of deformities. METHODS: We retrospectively reviewed 111 patients diagnosed with SO around the knee. The patients were classified into 2 groups depending on the location of the SO: 51 in the distal femur and 60 in the proximal tibia. Characteristics of the lesions, such as type, location, size, and distance from the joint line, were determined. Radiographic analysis of the lower limbs included mechanical lateral distal femoral angle, mechanical medial proximal tibial angle, whole-leg length, femoral length, and tibial length. RESULTS: The mean age at the time of diagnosis was 12.3±3.4 years. No statistically significant differences were found between the affected and contralateral sides for mechanical lateral distal femoral angle and mechanical medial proximal tibial angle in either the distal femur or the proximal tibia groups. In patients with femoral lesions, the femoral and whole-leg lengths were significantly shorter on the affected side than on the unaffected side ( P <0.001 and 0.002, respectively), and the mean differences were 2.1±3.6 and 2.1±4.4 mm, respectively. Univariate logistic regression analysis did not reveal any factors associated with limb length discrepancy (LLD). In patients with tibial lesions, no statistically significant differences were found in LLD. CONCLUSIONS: SOs around the knee did not cause clinically significant deformity of the lower extremity. However, in contrast to proximal tibia lesions, SO in the distal femur was associated with the shortening of the affected limb. Consideration should be given to the development of LLD in skeletally immature children with SO in the distal femur. LEVEL OF EVIDENCE: Level III-retrospective comparative study.

Associations of combined polygenic risk score and glycemic status with atrial fibrillation, coronary artery disease and ischemic stroke.

BACKGROUND: It is unknown whether high hemoglobin A1c (HbA1c) is associated with increases in the risk of cardiovascular disease among individuals with elevated genetic susceptibility. We aimed to investigate the association between HbA1c and atrial fibrillation (AF), coronary artery disease (CAD), and ischemic stroke according to the polygenic risk score (PRS). METHODS: The UK Biobank cohort included 502,442 participants aged 40-70 years who were recruited from 22 assessment centers across the United Kingdom from 2006 to 2010. This study included 305,605 unrelated individuals with available PRS and assessed new-onset AF, CAD, and ischemic stroke. The participants were divided into tertiles based on the validated PRS for each outcome. Within each PRS tertiles, the risks of incident events associated with HbA1c levels were investigated and compared with HbA1c < 5.7% and low PRS. Data were analyzed from November 2022 to May 2023. RESULTS: Of 305,605 individuals, 161,605 (52.9%) were female, and the mean (SD) age was 56.6 (8.1) years. During a median follow-up of 11.9 (interquartile range 11.1-12.6) years, the incidences of AF, CAD, and ischemic stroke were 4.6, 2.9 and 1.1 per 100 person-years, respectively. Compared to individuals with HbA1c < 5.7% and low PRS, individuals with HbA1c ≥ 6.5% and high PRS had a 2.67-times higher risk for AF (hazard ratio [HR], 2.67; 95% confidence interval (CI), 2.43-2.94), 5.71-times higher risk for CAD (HR, 5.71; 95% CI, 5.14-6.33) and 2.94-times higher risk for ischemic stroke (HR, 2.94; 95% CI, 2.47-3.50). In the restricted cubic spline models, while a U-shaped trend was observed between HbA1c and the risk of AF, dose-dependent increases were observed between HbA1c and the risk of CAD and ischemic stroke regardless PRS tertile. CONCLUSIONS: Our results suggest that the nature of the dose-dependent relationship between HbA1c levels and cardiovascular disease in individuals with different PRS is outcome-specific. This adds to the evidence that PRS may play a role together with glycemic status in the development of cardiovascular disease.

Gravity Line-Hip Axis Offset as a Guide for Global Alignment to Prevent Recurrent Proximal Junctional Kyphosis/Failure.

BACKGROUND AND OBJECTIVES: Proximal junctional kyphosis/failure (PJK/F) is a potentially serious complication after adult spinal deformity (ASD) corrective surgery. Recurrent PJK/F is especially troublesome, necessitating fusion extension and occasionally resulting in irreversible neurological deficits. The gravity line (GL) offers valuable insights into global sagittal balance. This study aims to examine the postoperative GL-hip axis (GL-HA) offset as a critical risk factor for recurrent PJK/F. METHODS: We retrospectively reviewed patients with ASD who had undergone revision surgery for initial PJK/F at a single academic center. Patients were categorized into 2 groups: nonrecurrent PJK/F group and recurrent PJK/F group. Demographics, surgical characteristics, preoperative and postoperative parameters of spinopelvic and global alignment, and the Scoliosis Research Society-22 scores were assessed. We examined these measures for differences and correlations with recurrent PJK/F. RESULTS: Our study included 32 patients without recurrent PJK/F and 28 patients with recurrent PJK/F. No significant differences were observed in baseline demographics, operative characteristics, or Scoliosis Research Society-22 scores before and after surgery. Importantly, using a cutoff of -52.6 mm from logistic regression, there were considerable differences and correlations with recurrent PJK/F in the postoperative GL-HA offset, leading to an odds ratio of 7.0 (95% CI: 1.94-25.25, P = .003). CONCLUSION: Postoperative GL-HA offset serves as a considerable risk factor for recurrent PJK/F in patients with ASD who have undergone revision surgery. Overcorrection, with GL-HA offset less than -5 cm, is associated with recurrent PJK/F. The instrumented spine tends to align the GL near the HA, even at the cost of proximal junction.

Evolution of neutralizing antibodies through vaccination and breakthrough infections in the era of COVID-19 endemicity.

Despite a high vaccination rate, the COVID-19 pandemic continues with immune-evading Omicron variants. The success of additional antigenic stimulation through breakthrough infection (BI) and updated vaccination in overcoming antigenic imprinting needs to be determined. Participants in a long-term follow-up cohort of healthcare worker (HCW) vaccinee were categorized according to their infection/vaccination status. Anti-SARS-CoV-2 spike/nucleocapsid protein antibodies were measured, and plaque reduction neutralization tests (PRNTs) against wild-type (WT), BA.5, BN.1, and XBB.1.5 were conducted. The neutralization activity of intravenous immunoglobulin (IVIG) products was evaluated to assess the immune status of the general population. Ninety-five HCWs were evaluated and categorized into seven groups. The WT PRNT ND50 value was highest regardless of infection/vaccination status, and groups with recent antigenic stimulation showed high PRNT titers overall. Groups with double Omicron stimulation, either by BI plus BA.4/5 bivalent vaccination or repeated BI, exhibited significantly higher BA.5 and BN.1 PRNT to WT PRNT ratios than those with single Omicron stimulation. Overall group immunity was estimated to be boosted in January 2023, reflecting the effect of the BA.4/5 bivalent booster and additional BIs, but slightly declined in June 2023. A substantial increase in the antibody concentrations of IVIG products was noticed in 2022, and recently produced IVIG products exhibited a substantial level of cross-reactive neutralizing activity against emerging variants. Neutralizing activity against emerging variants could be enhanced by repeated antigenic stimulation via BI and/or updated vaccination. Overall group immunity was elevated accordingly, and IVIG products showed substantial activity against circulating strains.

A fluorescent probe for selective detection of boric acids and its application for screening the conversion of the Suzuki-Miyaura coupling reaction.

Boric acid (B(OH)3) plays an important physiological role and is widely used as a food preservative and an antiseptic. Various colorimetric, fluorescent probes have been developed to detect boric acid; however, most of them could not discriminate boric acid over boronic acids (R-B(OH)2) or are limited to boronic acid sensors. Therefore, the development of boric acid-selective probes is necessary. Herein, a salicylimine-based fluorophore, Di-OH, was designed that showed selective fluorescence response to boric acid over boronic acid. Its fluorescence response to boric acid showed a large fluorescence turn-on signal up to 140 fold and excellent selectivity with various analytes. Furthermore, since boric acid is generated in proportion to the consumed boronic acid derivatives during reactions involving oraganoboron compounds, Di-OH allowed the determination of the conversion of the Suzuki-Miyaura coupling reaction using fluorescence spectroscopy and its correlation with the GC conversion was confirmed.

Hypoxia stabilizes SETDB1 to maintain genome stability.

Von Hippel-Lindau (VHL) is a tumor suppressor that functions as the substrate recognition subunit of the CRL2VHL E3 complex. While substrates of VHL have been identified, its tumor suppressive role remains to be fully understood. For further determination of VHL substrates, we analyzed the physical interactome of VHL and identified the histone H3K9 methyltransferase SETBD1 as a novel target. SETDB1 undergoes oxygen-dependent hydroxylation by prolyl hydroxylase domain proteins and the CRL2VHL complex recognizes hydroxylated SETDB1 for ubiquitin-mediated degradation. Under hypoxic conditions, SETDB1 accumulates by escaping CRL2VHL activity. Loss of SETDB1 in hypoxia compared with that in normoxia escalates the production of transposable element-derived double-stranded RNAs, thereby hyperactivating the immune-inflammatory response. In addition, strong derepression of TEs in hypoxic cells lacking SETDB1 triggers DNA damage-induced death. Our collective results support a molecular mechanism of oxygen-dependent SETDB1 degradation by the CRL2VHL E3 complex and reveal a role of SETDB1 in genome stability under hypoxia.

Longitudinal Degradation of Pavement Marking Detectability for Mobile LiDAR Sensing Technology in Real-World Use.

Recent advancements in vehicle automation and driver-assistance systems that detect pavement markings has increased the importance of the detectability of pavement markings through various sensor modalities across weather and road conditions. Among the sensing techniques, light detection and ranging (LiDAR) sensors have become popular for vehicle-automation applications. This study used low-cost mobile multi-beam LiDAR to assess the performance of several types of pavement marking materials installed on a limited-access highway in various conditions, and quantified the degradation in detection performance over three years. Four marking materials, HPS-8, polyurea, cold plastic, and sprayable thermoplastic, were analyzed in the current study. LiDAR reflectivity data extracted from a total of 210 passes through the test sections were analyzed. A new detectability score based on LiDAR intensity data was proposed to quantify the marking detectability. The results showed that the pavement marking detectability varied across the material types over the years. The results provide guidance for selecting materials and developing maintenance schedules when marking detectability by LiDAR is a concern.

Overgrowth of long bone in rabbits by growth stimulation through metaphyseal hole creation.

Overgrowth of long bones was noted in pediatric patients who underwent anterior cruciate ligament reconstruction. Hyperaemia during creating a metaphyseal hole and the microinstability made by the drill hole may induce overgrowth. This study aimed to determine whether metaphyseal hole creation accelerates growth and increases bone length and compare the effects of growth stimulation between metaphyseal hole creation and periosteal resection. We selected 7- to 8-week-old male New Zealand white rabbits. Periosteal resection (N = 7) and metaphyseal hole creation (N = 7) were performed on the tibiae of skeletally immature rabbits. Seven additional sham controls were included as age-matched controls. In the metaphyseal hole group, the hole was made using a Steinman pin at the same level of periosteal resection, and the cancellous bone beneath the physis was removed by curettage. The vacant space in the metaphysis below the physis was filled with bone wax. Tibiae were collected 6 weeks after surgery. The operated tibia was longer in the metaphyseal hole group (10.43 ± 0.29 cm vs. 10.65 ± 0.35 cm, P = 0.002). Overgrowth was higher in the metaphyseal hole group (3.17 ± 1.16 mm) than in the sham group (- 0.17 ± 0.39 mm, P < 0.001). The overgrowth in the metaphyseal hole group was comparable to that in the periosteal resection group (2.23 ± 1.52 mm, P = 0.287). In rabbits, metaphyseal hole creation and interposition with bone wax can stimulate long bone overgrowth, and the amount of overgrowth is similar to that seen in periosteal resection.

Impact of adjuvant therapy in patients with invasive intraductal papillary mucinous neoplasms of the pancreas: an international multicenter cohort study.

BACKGROUND: Adjuvant therapy prolongs survival in patients with pancreatic ductal adenocarcinoma. However, no clear guidelines are available regarding the oncologic effects of adjuvant therapy (AT) in resected invasive intraductal papillary mucinous neoplasms (IPMN). The aim was to investigate the potential role of AT in patients with resected invasive IPMN. MATERIALS AND METHODS: From 2001 to 2020, 332 patients with invasive pancreatic IPMN were retrospectively reviewed in 15 centres in eight countries. Propensity score-matched and stage-matched survival analyses were conducted. RESULTS: A total of 289 patients were enroled in the study after exclusion (neoadjuvant therapy, unresectable disease, uncertain AT status, and stage IV). A total of 170 patients were enroled in a 1:1 propensity score-matched analysis according to the covariates. In the overall cohort, disease-free survival was significantly better in the surgery alone group than in the AT group ( P =0.003), but overall survival (OS) was not ( P =0.579). There were no significant differences in OS in the stage-matched analysis between the surgery alone and AT groups (stage I, P =0.402; stage II, P =0.179). AT did not show a survival benefit in the subgroup analysis according to nodal metastasis (N0, P =0.481; N+, P =0.705). In multivariate analysis, node metastasis (hazard ratio, 4.083; 95% CI, 2.408-6.772, P <0.001), and cancer antigen 19-9 greater than or equal to 100 (hazard ratio, 2.058; 95% CI, 1.247-3.395, P =0.005) were identified as adverse prognostic factors in resected invasive IPMN. CONCLUSION: The current AT strategy may not be recommended to be performed with resected invasive IPMN in stage I and II groups, unlike pancreatic ductal adenocarcinoma. Further investigations of the potential role of AT in invasive IPMN are recommended.