Frailty and Vulnerability as Predictors of Chemotherapy Toxicity in Older Adults: A Longitudinal Study in Peru.

BACKGROUND: Multiple markers are used to assess frailty and vulnerability, conditions associated with the development of chemotherapy toxicity (CTT). However, there is still no consensus on which condition has stronger association with this adverse effect of chemotherapy in the elderly. OBJECTIVES: To evaluate the association between frailty and vulnerability with the development of CTT in oncogeriatric patients. DESIGN, SETTING, AND PARTICIPANTS: Through a retrospective cohort, a secondary database of 496 male oncogeriatric military patients treated at the Geriatrics Service of the Naval Medical Centre of Peru during 2013-2015 was analyzed. MEASUREMENTS: With prior informed consent, the presence of frailty, assessed by Fried Phenotype; and vulnerability, assessed by the Vulnerable Elders Survey-13 (VES-13) and G-8, was determined. The follow-up of patients in chemotherapy was performed every 8 weeks, to determine the development of CTT (according to the Common Terminology Criteria for Adverse Events v4.0). In addition, we included sociodemographic characteristics, medical background information and functional assessment variables. The data collected was encoded and imported into STATA v14.0 statistical package for analysis. Multivariate analysis was performed using crude and adjusted Cox regression models. The reported measure was the hazard ratio (HR) with their respective 95% confidence intervals (95%CI). RESULTS: The average age was 79.2 ± 4.3 years. 129 (26.01%) developed CTT during follow-up. Similarly, 129 older adults (26.01%) were positive for frailty according to Fried phenotype; 101 (20.36%) were positive for vulnerability with VES-13, and 112 (22.58%) with G-8. In the adjusted Cox model, by type of cancer and adverse effects, a statistically significant association was found between the 3 scales evaluated and the development of CTT, with the Fried Phenotype as the scale with the strongest association (HR=2.01; 95%CI: 1.04-4.90). CONCLUSIONS: The frailty and vulnerability in the elderly are conditions associated with the development of CTT. The Fried phenotype was the scale with the most significant association with the outcome studied.

Meta-analysis reveals that pollinator functional diversity and abundance enhance crop pollination and yield.

How insects promote crop pollination remains poorly understood in terms of the contribution of functional trait differences between species. We used meta-analyses to test for correlations between community abundance, species richness and functional trait metrics with oilseed rape yield, a globally important crop. While overall abundance is consistently important in predicting yield, functional divergence between species traits also showed a positive correlation. This result supports the complementarity hypothesis that pollination function is maintained by non-overlapping trait distributions. In artificially constructed communities (mesocosms), species richness is positively correlated with yield, although this effect is not seen under field conditions. As traits of the dominant species do not predict yield above that attributed to the effect of abundance alone, we find no evidence in support of the mass ratio hypothesis. Management practices increasing not just pollinator abundance, but also functional divergence, could benefit oilseed rape agriculture.

Low power RF amplifier circuit for ion trap applications.

A low power RF amplifier circuit for ion trap applications is presented and described. The amplifier is based on a class-D half-bridge amplifier with a voltage mirror driver. The RF amplifier is composed of an RF class-D amplifier, an envelope modulator to ramp up the RF voltage during the ion analysis stage, a detector or amplitude demodulation circuit for sensing the output signal amplitude, and a feedback amplifier that linearizes the steady state output of the amplifier. The RF frequency is set by a crystal oscillator and the series resonant circuit is tuned to the oscillator frequency. The resonant circuit components have been chosen, in this case, to operate at 1 MHz. In testings, the class-D stage operated at a maximum of 78 mW at 1.1356 MHz producing 225 V peak.

Access improvement to aircraft passengers' hand luggage.

BACKGROUND: Efficient use of space and passenger comfort in aircraft interiors are major issues. There is not much research available about the flying experience regarding passengers' personal belongings. OBJECTIVE: The objective of this study is to explore concepts within the current aircraft seats which improve the passenger experience related to their personal belongings like wallets, mobile phones and laptops. METHODS: Through on-site observations, interviews and online questionnaires, data regarding the number of personal belongings taken into the airplane and opinions about access to hand luggage were gathered. These data were used to develop different concepts to optimize the aircraft interior, which were evaluated by passengers. RESULTS: Almost every passenger carries a phone (88%), wallet (94%), travel documents (98%) and keys (76%) with them and they like to have these stored close by. Passengers rate the concept that provides integrated storage in the tray table of the aircraft seat the best. CONCLUSIONS: Extra storage possibility in the table-tray seems a promising solution according to the passengers.

Note: ion source design for ion trap systems.

A small plasma (glow discharge) based ion source and circuit are described in this work. The ion source works by producing a high voltage pulsed discharge between two electrodes in a pressure range of 50-100 mTorr. A third mesh electrode is used for ion extraction. The electrodes are small stainless steel screws mounted in a MACOR ionization chamber in a linear arrangement. The electrode arrangement is driven by a circuit, design for low power operation. This design is a proof of concept intended for applications on small cylindrical ion traps.

Characterization system for research on energy storage capacitors.

In this work a characterization system for high energy-density capacitors is described and demonstrated. Capacitors are being designed using thin-film technology in an attempt to achieve higher energy-density levels by operating the devices at a high voltage. These devices are fabricated from layers of 100 nm aluminum and a layer of polyvinylidene fluoride-hexafluoropropylene on a polyethylene naphthalate plastic substrate. The devices have been designed to store electrical charge at up to 200 V. Characterizations of these devices focus on the measurement of capacitance vs bias voltage and temperature, equivalent series resistance, and charge/discharge cycles. For the purpose of the characterization of these capacitors, an electronic charge/discharge interface was designed and tested.

Olfactomedin-like 3 (OLFML3) gene expression in baboon and human ocular tissues: cornea, lens, uvea, and retina.

BACKGROUND: Olfactomedin-like is a family of polyfunctional polymeric glycoproteins. This family has at least four members. One member of this family is OLFML3, which is preferentially expressed in placenta but is also detected in other adult tissues including the liver and heart. However, its orthologous rat gene is expressed in the iris, sclera, trabecular meshwork, retina, and optic nerve. METHODS: OLFML3 messenger amplification was performed by RT-PCR from human and baboon ocular tissues. The products were cloned and sequenced. RESULTS: We report OLFML3 expression in human and baboon eye. The full coding DNA sequence has 1221 bp, from which an open reading frame of 406 amino acid was obtained. The baboon OLFML3 gene nucleotidic sequence has 98% and amino acidic 99% similarity with humans. CONCLUSIONS: OLFML3 gene expression in human and baboon ocular tissues and its high similarity make the baboon a powerful model to deduce the physiological and/or metabolic function of this protein in the eye.

MHC class I chain-related gene B (MICB) is associated with rheumatoid arthritis susceptibility.

OBJECTIVES: Several recent studies have shown that the MHC class III region, located telomeric to HLA-DRB1, contains an additional genetic factor that predisposes to rheumatoid arthritis (RA). In this study, we investigate whether inhibitor of kappaB-like (IkappaBL), MICB or MICA located in the MHC class III region are the second susceptibility gene associated with RA. METHODS: A total of 154 healthy controls and 140 RA patients were genotyped for HLA-DRB1, MICA, MICB and the polymorphism -62 of the IkappaBL gene. RESULTS: A significant increase of HLA-DRB1 shared epitope (SE) alleles was detected in RA patients (61.4 vs 43.5%, P(c) = 0.01, OR = 2.1, 95% CI = 1.3-3.3). Among SE alleles, the HLA-DRB1*0401 (13.5 vs 5.1%, P(c) = 0.04, OR = 3.2, 95% CI = 1.3-8.1) and HLA-DRB1*0404 (6.4 vs 1.2%, P = 0.02, P(c) = NS) showed the most significantly association with RA. No increase of risk was associated with HLA-DRB1*01. Remarkably, the allele MICB*004 was also significantly associated with RA susceptibility (40.7 vs 23.3%, P(c) = 0.01, OR = 2.2, 95% CI = 1.3-3.7). MICB*004 was in linkage disequilibrium with HLA-DRB1*0404 (lambda(s) = 0.33) and HLA-DRB1*0405 (lambda(s) = 0.34). However, MICB*004 was also increased in HLA-DRB1 SE negative patients (37 vs 21.5%, P = 0.04). No significant association between IkappaBL and MICA with RA was found. CONCLUSIONS: MICB*004 allele was associated with RA susceptibility. This allele was in linkage disequilibrium with HLA-DRB1*0404 and DRB1*0405. The association of MICB with RA susceptibility and the functional role of MIC genes in the pathogenesis of RA converts MICB into a candidate to be an additional MHC gene associated with RA susceptibility.

Identification of Enterobacter bacteria as saxitoxin producers in cattle's rumen and surface water from Venezuelan Savannahs.

We have previously shown that a paralytic toxin able to block sodium channels in nerve is associated with a cattle disease known as bovine paraplegic syndrome (BPS) [Toxicon. 31 (1993) 1581]. We have now identified this as saxitoxin (STX) using HPLC by either the methods of [Toxicon. 31 (1993) 1581], or [Toxicon. 25 (1987) 1105]. In recent experiments we were able to collect and cultivate facultative anaerobic bacteria growing on rumen, grass and ponds of corrals with high incidence of BPS; the cultured bacteria produce compounds indistinguishable from STX under both HPLC procedures described above. Two species of the Enterobacter genus (E. asburiae and E. cloacae) and a strain of Klebsiella pneumoniae, were identified using standard biochemical criteria as well as gas chromatography of bacterial lipids. All these bacteria produced STX in aerobic cultures.

Resection of a plantar calcaneal spur using the holmium:yttrium-aluminum-garnet (Ho:YAG) laser.

Many procedures have been described for the resection of plantar calcaneal spurs as treatment of heel spur syndrome and chronic plantar fasciitis. Most of these techniques involve a medial incision of between 2 and 6 cm for adequate exposure of the calcaneal spur. This article describes a new technique for resecting a calcaneal spur with a smaller medial incision using the holmium:yttrium-aluminum-garnet (Ho:YAG) laser. This laser permits adequate resection of a plantar calcaneal spur as well as coagulation of the bone and surrounding tissues. This minimally invasive procedure has been used with good results over the past year by the senior author (W.K.S.) for the resection of calcaneal spurs.

[Evaluation of the effects of a school breakfast program on attention and memory]. / Evaluación de los efectos de un programa de desayunos escolares en atención y memoria.

The purpose of the study was to evaluate the impact of a school breakfast program in Sonora, Mexico. The study was conducted in four counties classified as extremely poor. Three hundred children from twelve schools pertaining to three counties under research received a school breakfast; one hundred and fifty children from four schools pertaining to a fourth county did not received school breakfast. Children were four to six years old. Attention, memory and cognition tests were applied before and after the program. Results showed an improvement for those groups receiving the breakfast program, specially on response speed and behavior executions. Group without breakfast showed better results on the pre-test, nevertheless, on the post-test, performances in both groups appear the same. At the beginning of school courses any county was different, but speed in selection and running show significatives differences for the schools. The program shows similar results on response speed, no matter social condition, nevertheless, program differentially affects the number of correct behavior executions on stimulus selection and reproduction. The breakfast program benefit children, but its effects are differentially distributed improving behavioral, repertories depending of children's group vulnerability.

Sinusitis fúngicas no invasivas: sinusitis fúngica alergica y micetomas sinusales / Non-invasive fungal sinusitis; allergic fungal sinusitis and sinusal mycetomas

Revisamos los casos de sinusitis fúngica (SF) no invasivas tratados en nuestra Unidad aplicando la reciente clasificación de las SF, basada en su fisiopatologÍa, tratamiento y pronóstico. Presentamos una serie de 7 casos de SF no invasivas tratados durante 2 años con un seguimiento mínimo de 24 meses. Se trata de dos SF alérgicas, una de ellas asociada a aspergilosis broncopulmonar alérgica, y de cinco micetomas, dos de ellos sin cuerpo extraño sinusal, de localización esfenoidal y maxilar respectivamente, y otros tres asociados a un cuerpo extraño maxilar. Todos ellosfueron tratados mediante cirugía endoscópica sinusal. En los casos de SF alérgica, fue preciso añadir tratamiento corticoides sistémicos en el postoperatorio. Se revisa la presentación de los distintos tipos de SF no invasivas, la importancia de la endoscopia y de las técnicas de imagen, la utilidad de la cirugía endoscópica sinusal para su tratamiento, la asociación frecuente de las SF con los cuerpos extraños sinusales, y su pronóstico (AU)

We review non-invasive fungal sinusitis (FS) cases treated at our Unit following the recent SF classification, based on physiopathology, treatment and prognosis. We report 7 FS cases treated during 2 years and followed a minimum of 24 months. They are two allergic FS, one of them related to an allergic bronchopulmonary aspergillosis, and five mycetomas, two of them without a sinusal foreign body, sphenoidal and maxillary respectively, and three caused by a maxillary foreign body. All were treated by endoscopic sinus surgery (ESS). The two allergic cases were also treated with systemic corticoids in the postoperative period. We review the clinical presentation of the different types of non-invasive FS, the importance of endoscopy and imaging techniques in their management, the usefulness of ESS, the common association of FS to foreign bodies, and their prognosis (AU)

[Non-invasive fungal sinusitis: allergic fungal sinusitis and sinusal mycetomas]. / Sinusitis fúngicas no invasivas: sinusitis fúngica alérgica y micetomas sinusales.

We review non-invasive fungal sinusitis (FS) cases treated at our Unit following the recent SF classification, based on physiopathology, treatment and prognosis. We report 7 FS cases treated during 2 years and followed a minimum of 24 months. They are two allergic FS, one of them related to an allergic bronchopulmonary aspergillosis, and five mycetomas, two of them without a sinusal foreign body, sphenoidal and maxillary respectively, and three caused by a maxillary foreign body. All were treated by endoscopic sinus surgery (ESS). The two allergic cases were also treated with systemic corticoids in the postoperative period. We review the clinical presentation of the different types of non-invasive FS, the importance of endoscopy and imaging techniques in their management, the usefulness of ESS, the common association of FS to foreign bodies, and their prognosis.

Dye affinity adsorbent replacement optimization.

A method to determine the optimal replacement time for dye affinity adsorbents used in protein purification processes that are subjected to severe regeneration conditions has been developed. To demonstrate the utility of the method, an experimental fixed-bed decay model was employed to determine the optimum number of cycles for the adsorbent replacement. This number is a function of the column regeneration frequency and of the capital and operation costs. The implications of the results on the design and operation of dye-ligand chromatographic processes are discussed.

A direct adaptive neural-network control for unknown nonlinear systems and its application.

In this paper a direct adaptive neural-network control strategy for unknown nonlinear systems is presented. The system considered is described by an unknown NARMA model, and a feedforward neural network is used to learn the system. Taking the neural network as a neural model of the system, control signals are directly obtained by minimizing either the instant difference or the cumulative differences between a set point and the output of the neural model. Since the training algorithm guarantees that the output of the neural model approaches that of the actual system, it is shown that the control signals obtained can also make the real system output close to the set point. An application to a flow-rate control system is included to demonstrate the applicability of the proposed method and desired results are obtained.

Contact and noncontact transscleral neodymium:YAG laser cyclophotocoagulation in a rabbit model.

PURPOSE: Contact versus noncontact transscleral neodymium:YAG laser cyclophotocoagulation was compared in a rabbit model with respect to the effects on intraocular pressure and pathologic findings. METHODS: Thirty-two rabbits received comparable energy levels (2 joules) of contact and noncontact cyclophotocoagulation. Pneumotonometry was performed every other day following treatment. RESULTS: For both the 2-week and 8-week periods following treatment, intraocular pressure was significantly lower in eyes receiving contact cyclophotocoagulation than in eyes receiving noncontact cyclophotocoagulation (for the 2-week period, mean difference in intraocular pressure was 5.3 mm Hg, n = 22, p < 0.001; for the 8-week period, mean difference in intraocular pressure was 4.3 mm Hg, n = 17, p < 0.013). Pathologic findings include acute ciliary body hemorrhage and inflammation (1 day), chronic inflammation (1 week), granulation tissue within laser lesions (2 weeks), and marked ciliary body atrophy (8 weeks). CONCLUSIONS: In our rabbit model, contact cyclophotocoagulation was more effective in lowering intraocular pressure than noncontact cyclophotocoagulation. Both contact and noncontact cyclophotocoagulation produced a variety of pathologic lesions in the rabbit eye, including cataract, phthisis bulbi, and anterior synechiae.

Decrease in detectable complement receptor type 1 levels on erythrocytes from patients with psoriatic polyarthritis.

The complement receptor type 1 (CR1) levels on erythrocyte membranes from 23 patients with PsA was determined by using ELISA. Six patients had an axial form, the rest had peripheral arthritis (10 polyarthritis and seven oligoarthritis). A significant decrease in levels of this receptor was found in patients with polyarthritis compared with healthy controls. Non-significant differences were found when comparing the other two groups of patients with the controls, although the mean values of CR1 were lower in the patients' group. We also found an inverse correlation between CR1 levels and articular index, but not with ESR, CRP or disease duration. No differences in the CR1 density were obtained for HLA-B27 positive and HLA-B27 negative patients.

[Strategy for monitoring and implementing methods for correcting child growth and development in rural areas of Sonora. Mexico]. / Estrategia del monitoreo e implementación de métodos correctivos sobre el crecimiento y desarrollo del niño en zonas rurales en Sonora. México.

An appropriate health technology to facilitate child growth and development in a rural area is presented and documented. Because mother's adequate behavior related to child's care does not produce immediate behavioral or physical changes it is necessary to create a long term social system of consequences. This was achieved joining a longitudinal measurement system with a program to train mothers to identify and deal with health and development issues. During four years, data were collected on weight-length development and morbidity twice a year and simultaneously skills were taught to diagnose treatment and prevent growth and development problems. After the third session child development and anthropometry data became the base of a system to assess maternal behavior, providing consequences for links in the behavior chains associated with child care. This system made organization and participation of the community in primary health care programs more likely, which implied a better score in each child growth and development chart.

Psoriatic arthritis (PA): a clinical, immunological and radiological study of 180 patients.

We carried out a prospective study of the clinical, laboratory and radiological features of 180 patients with psoriatic arthritis. We initially classified our patients into five groups as described in the publications of Moll and Wright. Thirty-seven per cent had oligoarthritis, 36% polyarthritis, 23% spondarthritis (sacroiliitis and/or spondylitis) and 4% had the mutilans form. The distal joint arthritis type did not exist as an entity and the distal interphalangeal (DIP) joints were affected in all groups. The spondarthritis form includes patients with exclusively axial manifestations and also those who in addition have peripheral arthritis (oligoarthritis, polyarthritis, DIP arthritis). Only 53% of our patients had nail involvement. We found an increase of IgA levels in patients with axial disease. This suggests a relationship between ankylosing spondylitis and psoriatic spondylitis. The HLA-B17/Cw6 association increased in the oligoarticular form. The increase of antigen B17 correlated with the spondarthritic and oligoarthritis forms whereas Cw6 was more important in the oligoarthritis form. An increase of the HLA-B27/Cw1 association and the spondarthritic form was also found. Moreover, we detected a greater incidence of the HLA-B27 antigen in patients with bilateral sacroiliitis (85%) than in patients with unilateral sacroiliitis (22%). Our work revealed that PA is not a harmless disease; 57% of our patients had erosive arthritis while 19% had ARA class III or IV functional impairment.