Single-point and kinetics of peripheral residual disease by mass spectrometry to predict outcome in patients with high risk smoldering multiple myeloma included in the GEM-CESAR trial.

The value of quantitative immunoprecipitation mass spectrometry (QIP-MS) to identify the M-protein is being investigated in patients with monoclonal gammopathies but no data are yet available in high-risk smoldering myeloma (HRsMM). We have therefore investigated QIP-MS to monitor peripheral residual disease (PRD) in 62 HRsMM patients enrolled in the GEM-CESAR trial. After 24 cycles of maintenance, detecting the M-protein by MS or clonal plasma cells by NGF identified cases with a significantly shorter median PFS (mPFS; MS: not reached vs 1,4 years, p=0.001; NGF: not reached vs 2 years, p=0.0002) but reaching CR+sCR did not discriminate patients with different outcome. With NGF as a reference, the combined results of NGF and MS showed a high negative predictive value (NPV) of MS: 81% overall and 73% at treatment completion. When sequential results were considered, sustained negativity by MS or NGF was associated with a very favorable outcome with a mPFS not yet reached vs 1.66 years and 2.18 years in cases never attaining PRD or minimal residual disease (MRD) negativity, respectively. We can thus conclude that 1) the standard response categories of the IMWG do not seem to be useful for treatment monitoring in HRsMM patients, 2) MS could be used as a non-invasive, clinical valuable tool with the capacity of guiding timely bone marrow evaluations (based on its high NPV with NGF as a reference) and 3) similarly to NGF, sequential results of MS are able identify a subgroup of HRsMM patients with long-term disease control. This study was registered at www.clinicaltrials.gov (ClinicalTrials.gov identifier: NCT02415413).

Psychophysiological Responses in Soldiers during Close Combat: Implications for Occupational Health and Fitness in Tactical Populations.

This study explores the psychophysiological responses and subjective exertion experiences of soldiers in simulated hand-to-hand combat, aligning these findings with established physiological benchmarks. Active military personnel were monitored for heart rate, blood lactate levels, subjective exertion, cortical arousal, and muscle strength during combat scenarios. The results showed significant increases in heart rate and blood lactate, indicating intense cardiovascular demands and a reliance on anaerobic energy systems. Contrary to these physiological changes, soldiers reported lower levels of exertion, suggesting a possible underestimation of physical effort or individual differences in perception and mental resilience to stress. Notably, a decrease in cortical arousal post-combat was observed, potentially signaling cognitive function deficits in decision-making and information processing in high-stress environments. This decline was more pronounced than typically seen in other high-stress situations, highlighting the unique cognitive demands of hand-to-hand combat. Additionally, an increase in muscle strength was noted, underscoring the physiological adaptations arising from intensive combat training. These findings provide valuable insights into the psychophysiological effects of hand-to-hand combat, emphasizing the complex interplay between physical exertion, cognitive function, and stress response in military contexts. The study underscores the need for comprehensive training strategies that address both physical and psychological aspects to enhance combat readiness and decision-making under stress.

Reference Values to Assess Hemodilution and Warn of Potential False-Negative Minimal Residual Disease Results in Myeloma.

BACKGROUND: Whereas, in most patients with multiple myeloma (MM), achieving undetectable MRD anticipates a favorable outcome, some others relapse shortly afterwards. Although one obvious explanation for this inconsistency is the use of nonrepresentative marrow samples due to hemodilution, there is no guidance on how to evaluate this issue. METHODS: Since B-cell precursors, mast cells and nucleated red blood cells are normally absent in peripheral blood, we analyzed them in 1404 bone marrow (BM) aspirates obtained in numerous disease settings and in 85 healthy adults (HA). RESULTS: First, we confirmed the systematic detection of the three populations in HA, as well as the nonreduced numbers with aging. Pairwise comparisons between HA and MM patients grouped according to age and treatment showed significant variability, suggesting that hemodilution should be preferably evaluated with references obtained from patients treated with identical regimens. Leveraging the MRD results from 118 patients, we showed that a comparison with HA of similar age could also inform on potential hemodilution. CONCLUSIONS: Our study supports the routine assessment of BM cellularity to evaluate hemodilution, since reduced BM-specific cell types as compared to reference values (either treatment-specific or from HA if the former are unavailable) could indicate hemodilution and a false-negative MRD result.

Could Combat Stress Affect Journalists' News Reporting? A Psychophysiological Response.

Covering war conflicts may compromise the psychological and physical health of journalists because chronic exposure to these environments has been related to depression, memory dissociative processes, and post-traumatic stress disorder; however, acute effects have not been studied yet. Thus, a combat simulation was carried out replicating actual warfare scenarios, including personnel and equipment. Psychophysiological response, memory, and information-processing were analysed of 40 professional soldiers (21 males and 19 females) and 19 journalists (12 males and 7 females) with international experience in current conflict areas such as Afghanistan, Iraq, Bosnia and Herzegovina, and Kosovo, in relation to their experience of a combat intervention. A significant increase (p < 0.05) in metabolic, muscular, cardiovascular, and cortical and psychological anxiety response, as well as a decrease in memory accuracy directly after and 24 h and 72 h post-combat were found; these modifications were modulated by the nature of the stimulus. Journalists presented higher cognitive and memory impairment than soldiers, resulting in a press reporting of real events accuracy of only 27%.

Incidence of spinal cancer in a tertiary care hospital in Mexico / Incidência de câncer da coluna vertebral em um hospital de terceiro nível de atenção no México / Incidencia de cáncer de columna vertebral en un hospital de tercer nivel de atención en México

ABSTRACT Objective To determine the incidence of primary malignant bone tumors of the spine in a High Specialty Orthopedics and Traumatology Medical Unit. Methods Review study. The study included patients receiving benefits from the Mexican Social Security Institute of all ages and both sexes with malignant spinal bone tumors during the period from 2010 to 2017. The descriptive statistics used were central tendency measures and dispersion in the SPSS v. 22 program from IBM. The results are presented in tables and figures. Results There were 107 patients, 56 (52.34%) men, 51 (47.66%) women with a mean age of 59.75 + 10.76 years (minimum 35, maximum 88). There were 46,840 hospital discharges during the period, for an annual average of 5,855 and a monthly average of 487.91. Of the 107 study cases, 78 (72.89%) were in the lumbosacral, 15 (14.01%) in the cervical, and 14 (13.08%) in the thoracic region. The incidence for the period was 1.9/1000 discharges, 1.38in 2010 increasing to 2.32 in 2017. Conclusions The behavior of primary malignant spinal tumors has increased its presentation from 2010 to 2017 . Level of evidence III; Non-analytical, descriptive study.

RESUMO Objetivo Conhecer a incidência de tumores ósseos malignos primários da coluna vertebral em uma unidade médica de alta especialidade médica em Ortopedia e Traumatologia. Métodos Estudo de revisão. O período do estudo incluiu os anos de 2010 a 2017 incluindo pacientes com tumores ósseos malignos da coluna vertebral, de todas as idades e ambos os sexos e usuários do IMSS (Instituto Mexicano de Seguridade Social). Foram utilizadas medidas estatísticas descritivas de tendência central e de dispersão no programa SPSS v. 22 IBM. Os resultados são apresentados em tabelas e gráficos. Resultados O estudo incluiu 107 pacientes, 56 (52,34%) homens e 51 mulheres (47,66%); idade média 59,75 + 10,76 anos (mínima 35, máxima 88). As altas hospitalares durante o período foram 46840, média anual de 5855 e média mensal de 487,91; dos tumores malignos 78 (72,89%) foram na região lombossacra, 15 (14,01%) na região cervical e 14 (13,08%) na região torácica. A incidência do período foi de 1,9/1000 altas, 1,38 em 2010, aumentando para 2,32 em 2017. Conclusões O comportamento dos tumores malignos primários da coluna vertebral tem aumentado desde 2010 a 2017. Nível de evidência III; Estudo analítico-descritivo.

RESUMEN Objetivo Conocer la incidencia de tumores óseos malignos primarios de columna vertebral en una Unidad Médica de Alta Especialidad en Ortopedia y Traumatología. Métodos Estudio de revisión. El período de estudio comprendió los años 2010 a 2017, incluyendo a pacientes con tumores óseos malignos de columna vertebral, de todas las edades y ambos sexos, y usuarios del IMSS (Instituto Mexicano del Seguro Social). Fueron utilizadas medidas estadísticas descriptivas de tendencia central y de dispersión en el programa SPSS v. 22 de IBM. Los resultados son presentados en tablas y gráficos. Resultados El estudio incluyó a 107 pacientes, 56 hombres (52,34%), y 51 mujeres (47,66%); edad promedio 59,75 + 10,76 años (mínima 35, máxima 88). Las altas hospitalarias durante el período fueron 46840, promedio anual de 5855 y promedio mensual de 487,91; de los tumores malignos, 78 (72,89%) casos en la región lumbosacra, 15 (14,01%) en la región cervical y 14 (13,08 %) en la región torácica. La incidencia del período fue 1,9/1000 altas, 1,38 en 2010, aumentando para 2,32 en 2017. Conclusiones El comportamiento de los tumores malignos primarios de columna vertebral ha aumentado desde 2010 a 2017. Nivel de evidencia III; Estudio analítico-descriptivo.

Effect of Experience and Psychophysiological Modification by Combat Stress in Soldier's Memory.

The present research aimed to analyze the effect of experience and psychophysiological modification by combat stress in soldier's memory in a simulated combat situation. Variables of rate of perceived exertion, blood glucose, blood lactate, lower body muscular strength manifestation, cortical arousal, specific fine motor skills, autonomic modulation, state anxiety, and memory and attention through a postmission questionnaire were analyzed before and after a combat simulation in 15 experienced soldiers of a special operation unit and 20 non-experienced soldiers of light infantry unit from the Spanish Army. The stress of combat simulation produces a significant increase (p < 0.05) in rated perceived exertion, blood glucose, blood lactate, somatic anxiety and a low frequency domain of the heart rate, and a significant decrease of rifle magazine reload time, high frequency domain of the heart rate and somatic anxiety in both groups. The variables of RPE, glucose, CFFT, RMRT, RMSSD, LF/HF, CA, SA and STAI were significantly different in experienced soldiers shown the activation of fight-flight system. The anticipatory anxiety in experienced soldiers shows a cognitive behavioral association by past experiences. The analysis of correct response in the postmission questionnaire show elements more related with the sight and that endanger the physical integrity of soldiers are more remembered, and some significant differences (p < 0.05) in the memory performance of experienced soldiers and non experienced soldiers where experienced soldiers shown a better performance. As conclusion, combat stress produce an increase in the psichophysiological response of soldiers independently of experience, but experienced ones presented a lower negative effect on memory than non experienced.

Validez factorial del cuestionario sobre trato digno en enfermería / Review of the effect of uncertainty in adults with type 2 diabetes mellitus

Introducción: Ofrecer un trato digno a los pacientes es un componente central en la calidad de los servicios de salud, por lo que su medición válida resulta altamente relevante. Objetivo: Evaluar la validez de constructo del cuestionario Trato digno en enfermería, desarrollado por la Secretaría de Salud en México. Métodos: Estudio observacional, transversal y analítico. Se seleccionó una muestra por conveniencia, la cual estuvo constituida por 355 pacientes atendidos en el 100% de los 89 centros de salud. Resultados: Hubo en promedio de puntuaciones altas de trato digno (0.84, rango 0-1)), el ajuste del modelo resultó adecuado al considerar diversos índices: NNFI = 0.99; NFI = 0.98; CFI = 0.99; RMSEA = 0.04; PNFI = 0.70 y chi cuadrada normada = 2.37. Un hallazgo notable fue la correlación positiva (p < 0.05) entre las dimensiones de relaciones humanas con la dimensión comunicativa (r = 0.95), relaciones humanas con la dimensión interior de la persona (r = 0.90) y dimensión comunicativa con dimensión interior de la persona (r = 0.90). Conclusión: Se comprobó la validez de constructo del cuestionario Trato digno en enfermería.

Introduction: Providing dignified care to patients is one of the main components in health care quality, which is why measuring it is really important. Objective: To evaluate the construct validity of the Dignified Care questionnaire in nursing, this was developed by the Secretaría de Salud (Mexico's Health Secretary). Methods: Observational, cross-sectional, and analytical study. 355 patients, attended in all the 89 health centers, were selected by convenience sampling. Results: There were on average high punctuations of dignified care (0.84, range 0,1). The adjustment of the model was appropriate, since several indexes were considered: NNFI = 0.99; NFI = 0.98; CFI = 0.99; RMSEA = 0.04; PNFI = 0.70 and normalized chi squared = 2.37. A remarkable finding was the positive correlation between the following dimensions (p < 0.05): human relations with communication (r = 0.95), human relations with the patient's inner dimension (r = 0.90), and communication with the patient's inner dimension (r = 0.90). Conclusions: Construct validity of the Dignified Care questionnaire in nursing was confirmed.

Psychophysiological response to the use of nuclear, biological and chemical equipment with military tasks.

The current military training requires the development and optimization of different strategies to improve performance in extreme conditions as well as the possible risk of suffering attacks with chemical and/ or radioactive substances. It turns out mandatory to research the psychophysiological response of soldiers and sanitary personnel when wearing the nuclear, biological and chemical (NBC) equipment. A longitudinal prospective experimental quantitative study has been developed, using a pre-treatment and post-treatment design. A total of 20 soldiers (33.3 ±â€¯5.4 years), belonging to the Spanish Armed Forces have been analyzed, divided into two groups, when carrying out different training activities designed to that effect. The following variables were analyzed right before and after accomplishing the different tasks: heart rate, heart variability, thermoregulation, blood glucose, explosive strength, perceived effort and motion performance in a munitioning task. The results showed a significant increase (p < 05) in heart rate, blood glucose, perceived effort and the time required when developing the triage tasks and when putting a tourniquet on other person in the group wearing NBC equipment compared to the other group, as well as a longer time required in a munitioning task. These results highlight the importance of training and preparing the sanitary and military personnel in the use of NBC equipment.

Use of Psychophysiological Portable Devices to Analyse Stress Response in Different Experienced Soldiers.

Previous studies have shown that actuate stress have a negative effect on working memory, visio-spatial ability and symptoms of disassociation. We conducted the present research with the aim of to analyse the effect of experience and training in psychophysiological response, attention and memory of soldiers in combat. Variables of blood lactate, blood glucose, blood oxygen saturation, body temperature, heart rate, lower body muscular strength manifestation, autonomic modulation, cortical arousal, cognitive and somatic anxiety, and memory by a post mission questionnaire were analysed before and after a combat simulation in 49 soldiers of Spanish Army. Combat simulation produced a significant increase (p < 0.05) in blood lactate, blood glucose, blood oxygen saturation, rated perceived exertion, heart rate, cognitive and somatic anxiety. Significant increase in low frequency domain and significant decrease in high frequency domain of the heart rate variability was found in experienced and highly trained soldiers. The percentage of correct response in the post mission questionnaire indicated that elements better remembered were those related with soldier integrity and considered as a possible life threat, Significant differences in the post mission questionnaire by experience and training was also found. Correlation analysis showed that higher psychophysiological activation correlated positively with cognitive impairment and lower memory. As a conclusion, higher experienced soldiers presented higher physiological activation as well as cognitive and memory impairment than lower experienced soldier after a combat simulation and memory function was modulated by the stimulus nature.

Effectiveness of Psycho-Physiological Portable Devices to Analyse Effect of Ergogenic Aids in Military Population.

Caffeine is one of the ergogenic substances most used by warfighters in current operation areas, but the effect on the organic response and operational performed is already poor knowledge. This research aimed to study the acute effect of 400 mg of caffeine monohydrate on the psycho-physiological response and rifle marksmanship of warfighters during a close quarter combat simulation. We analysed parameter of heart rate, blood lactate, cortical arousal, state anxiety and marksmanship of 20 Spanish Army veteran warfighters before and after a close quarter combat simulation in a double-blind procedure, also a correlation analysis was conducted between all the study variables. Marksmanship of warfighters did not improve with the caffeine ingestion, but it produced an increase in blood lactate concentration (caffeine: 1.9 ± 0.5 vs. 9.2 ± 1.1 mmol.l-1; placebo: 1.8 ± 0.7 vs. 6.9 ± 2.2 mmol.l-1), cortical arousal (% of change: caffeine: 2.51; placebo: -1.96) and heart rate (caffeine: 80.0 ± 7.2 vs. 172.9 ± 28.2 bpm; placebo: 79.3 ± 6.4 vs. 154.0 ± 26.8 bpm). In addition, higher heart rate values correlated negatively with marksmanship in close quarter combat. We concluded that caffeine intake did not improve the warfighters rifle marksmanship in close quarter combat possibly due to the increase in the physiological response.

Inalambric Biofeedback Devices to Analyze Strength Manifestation in Military Population.

The study of the effect of stress on both combatants physiological and anatomical systems have been poor studied in the specific literature. The present research aimed to study the effect of combat stress in strength manifestations of leg flexor-extensor muscles and the anaerobic metabolism of soldiers. Before and after asymmetrical combat simulation were analyzed parameters of blood lactate concentration, explosive leg strength manifestation and contractile capacity of leg muscle in 186 professional soldiers. Results showed a significant increase (p < 0.05) in blood lactate values (2.23 ± 0.95 vs 7.47 ± 3.67 mmol/L), explosive leg strength (Squat Jump 0.31 ± 0.06 vs 0.35 ± 0.07 m, Countermovement Jump 0.33 ± 0.07 vs 0.36 ± 0.07 m, Abalakov Jump 0.39 ± 0.08 vs 0.41 ± 0.09 m), and a significant decrease of the elastic capacity (0.022 ± 0.04 vs 0.021 ± 0.04) and recruitment and muscle synchronization capability (0.028 ± 0.04 vs 0.026 ± 0.04). This data suggest that combat stress increases the leg strength manifestation despite the significantly increase of muscle acidosis after a combat simulation. This result is probably due to the high activation of the fight-flight system of soldiers which increases the organic response of soldiers and that can compensate the prejudicial effect of acidosis in muscle contraction. These results could be used by officers to improve specific training programs and to improve planning and election of equipment and material for the development of different missions in current theaters of operations.

Psychophysiological response to acute-high-stress combat situations in professional soldiers.

The study of psychophysiological responses of soldiers in combat situations remains a challenge, especially in melee combat-a close proximity unarmed fight-defined by high unpredictability. Gaining knowledge about psychophysiological changes in high-stress situations is required to optimise training. This study aimed to analyse modifications in autonomic modulation, cortical arousal, heart rate, muscle strength, blood lactate concentration, and rating of perceived exertion of veteran soldiers in a melee combat simulation. Twenty veteran soldiers were analysed before and after a melee combat simulation in accordance with realistic situations that occur in actual operations areas. The simulation consisted of actions performed by a binomial unit in a security and protection mission in an operations area. The melee combat caused an increase in sympathetic modulation, blood lactate concentration, heart rate, muscle strength, a decreased tendency in cortical arousal, and a lower rating of perceived exertion than the organic response measured. An intense fight-flight response was observed in soldiers by the limbic system activation, causing a misinterpretation of perceived exertion. Finally, implications for the design of simulation environments for tactics training in high-stress professions are discussed.

Psychophysiological Response and Fine Motor Skills in High-Altitude Parachute Jumps.

Clemente-Suárez, Vicente Javier, José Juan Robles-Pérez, Ketty Herrera-Mendoza, Beliña Herrera-Tapias, and Jesús Fernández-Lucas. Psychophysiological response and fine motor skills in high-altitude parachute jumps. High Alt Med Biol 18:392-399, 2017.-We analyzed the psychophysiological response and specific fine motor skill of an experienced jumper in HALO (high altitude low opening) and HAHO (high altitude high opening) parachute jumps. Eight HALO and eight HAHO jumpers were analyzed. They jumped at 5500 m, HALO jumpers opened the parachute at 500 m and HAHO jumpers at 4300 m of altitude. Before and after the jumps, parameters of muscle strength, cortical arousal, blood creatine kinase (CK) and glucose, blood oxygen saturation, rate of perceived exertion (RPE), and specific fine motor skills of an experienced jumper were assessed; during the jump, heart rate (HR), HR variability, and speed were evaluated. HALO and HAHO jumps produced a significant increase in CK, lactate, and RPE, and a decrease in glucose. HAHO decreased cortical arousal, presented a higher sympathetic modulation, and a higher HR during the jump than HALO. HALO and HAHO produced an increase in the physiological, sympathetic modulation and muscle destruction, and a decrease in cortical arousal and a higher blood lactate concentration only in the HAHO jump. Also, somatic and cognitive anxiety correlated with higher strength manifestation and muscle destruction. This novel research could be used to improve actual training systems in both civil and military parachute jumpers.

Use of Minicameras to Improve Operative Procedure in Security Forces.

The aim of the present study was to analyze pistol and compact rifle marksmanship in close quarter combat (CQC). There is currently a controversy about what weapon is most appropriate to use in CQC, short weapon as pistols or long weapons as rifle. Forty two participants conducted two close quarter combat simulations, one with pistol and one with compact rifle. Marksmanship and time to cover the simulation were measured. Data obtained showed no significant differences between pistol and compact rifle. In addition, it was observed a tendency to obtain higher scores with compact rifle, probably be due to the higher stability provided in the shot action. Compact rifle could be an effective election in actual theaters of operation in which asymmetrical and symmetrical combat are combined and also in police interventions due to compact rifle provide higher fire power and range and obtained the same shooting performance than pistol. To the best of our knowledge this is the first study that provides empirical data to solve the discussion about the efficiency of the use of rifle and pistol in close quarter combat in military and police interventions. These results could be used to improve the military and police interventions efficiency.

Combat Stress Decreases Memory of Warfighters in Action.

The present research aimed to analyze the effect of combat stress in the psychophysiological response and attention and memory of warfighters in a simulated combat situation. Variables of blood oxygen saturation, heart rate, blood glucose, blood lactate, body temperature, lower body muscular strength manifestation, cortical arousal, autonomic modulation, state anxiety and memory and attention through a postmission questionnaire were analyzed before and after a combat simulation in 20 male professional Spanish Army warfighters. The combat simulation produces a significant increase (p < 0.05) in explosive leg strength, rated perceived exertion, blood glucose, blood lactate, somatic anxiety, heart rate, and low frequency domain of the HRV (LF) and a significant decrease of high frequency domain of the heart rate variability (HF). The percentage of correct response in the postmission questionnaire parameters show that elements more related with a physical integrity threat are the most correctly remembered. There were significant differences in the postmission questionnaire variables when participants were divided by the cortical arousal post: sounds no response, mobile phone correct, mobile phone no response, odours correct. The correlation analysis showed positive correlations: LF post/body temperature post, HF post/correct sound, body temperature post/glucose post, CFFTpre/lactate post, CFFT post/wrong sound, glucose post/AC pre, AC post/wrong fusil, AS post/SC post and SC post/wrong olfactory; and negative correlations: LF post/correct sound, body temperature post/lactate post and glucose post/lactate post. This data suggest that combat stress actives fight-flight system of soldiers. As conclusion, Combat stress produces an increased psychophysiological response that cause a selective decrease of memory, depending on the nature, dangerous or harmless of the objects.

Psychophysiological response in parachute jumps, the effect of experience and type of jump.

We aimed to analyse the effect of experience and type of parachute jump on the psychophysiological responses of jumpers. We analysed blood oxygen saturation, heart rate, blood glucose, lactate and creatinkinase, leg strength, isometric hand strength, cortical arousal, specific fine motor skills, self-confidence and cognition, and somatic and state anxiety, before and after four different parachute jumps: a sport parachute jump, a manual tactical parachute jump, tandem pilots, and tandem passengers. Independently of the parachute jump, the psychophysiological responses of experienced paratroopers were not affected by the jumps, except for an increase in anaerobic metabolism. Novice parachute jumpers presented a higher psychophysiological stress response than the experienced jumpers, together with a large anticipatory anxiety response before the jump; however, this decreased after the jump, although the high physiological activation was maintained. This information could be used by civil and military paratroopers' instructors to improve their training programmes.

Effect of Combat Stress in the Psychophysiological Response of Elite and Non-Elite Soldiers.

We aimed to analyse the effect of combat stress in the psychophysiological responses of elite and non-elite soldiers. We analysed heart rate, cortical arousal, skin temperature, blood lactate concentration and lower body muscular strength before and after a tactical combat simulation in 40 warfighters divided in two groups: elite (n: 20; 28.5 ± 6.38 years) and non-elite (n:20; 31.94 ± 6.24 years) group. Elite presented a significantly higher lactate concentration after combat than non elite soldiers (3.8 ± 1.5 vs 6.6 ± 1.3 mmol/L). Non-elite soldiers had a higher heart rate pre and post the simulation than elite (82.9 ± 12.3 vs 64.4 ± 11. pre non elite and elite respectively; 93.0 ± 12.8 vs 88 ± 13.8 bpm post non elite and elite respectively). Elite soldiers presented higher lower muscular strength than elite in all test and before and after the combat simulation. Cortical arousal was not modified significantly in both groups. We conclude elite soldiers presented in combat a higher anaerobic metabolism activation and muscular strength than non-elite soldiers, but cardiovascular, cortical, and muscular strength manifestation presented the same response in both elite and non-elite soldiers.

Psycho-physiological response in an automatic parachute jump.

Parachute jump is an extreme activity that elicits an intense stress response that affects jumpers' body systems being able to put them at risk. The present research analysed modifications in blood oxygen saturation (BOS), heart rate (HR), cortisol, glucose, lactate, creatine kinase (CK), muscles strength, cortical arousal, autonomic modulation, pistol magazine reload time (PMRT) and state anxiety before and after an automatic open parachute jump in 38 male Spanish soldiers (25.6 ± 5.9 years). A MANOVA with samples as a fixed factor and Effect Size (ES) were conducted. MANOVA showed (Wilks lambda = .225; F = 5.980; P = .000) a significantly increase in cortisol (6.2 ± 3.2 vs. 8.2 ± 4.3 nmol/l; P = .025; ES = .47), HR (75.0 ± 14.6 vs. 87.4 ± 17.3 bpm; P = .004; ES = .72), lactate (1.8 ± 1.2 vs. 4.4 ± 2.2 mmol · l-1; P = .002; ES = 1.18), sympathetic nervous system and leg strength manifestation after the parachute jump. By contrary BOS, PMRT (55.6 ± 27.6 vs. 48.0 ± 16.7 s; P = .021; ES = .46) and somatic anxiety (SA), evaluated by CSAI2R questionnaire, decreased. An automatic parachute jump increased physiological and cortical response and decreased SA of participants. This stress response can affect the jumpers' abilities and allow us to have a better understanding of the organism stress response and to improve training for both military and sport parachute jumps.

Experience modulates the psychophysiological response of airborne warfighters during a tactical combat parachute jump.

We aimed to analyse the effect of experience level in the psychophysiological response and specific fine motor skills of novel and expert parachute warfighters during a tactical combat parachute jump. We analysed blood oxygen saturation, heart rate, salivary cortisol, blood glucose, lactate and creatinkinase, leg strength, isometric hand-grip strength, cortical arousal, specific fine motor skills and cognitive anxiety, somatic anxiety and self-confident before and after a tactical combat parachute jump in 40 warfighters divided in two group, novel (n=17) and expert group (n=23). Novels presented a higher heart rate, lactate, cognitive anxiety, somatic anxiety and a lower self-confident than experts during the jump. We concluded that experience level has a direct effect on the psychophysiological response since novel paratroopers presented a higher psychophysiological response than compared to the expert ones, however this result neither affected the specific fine motor skills nor the muscle structure after a tactical combat parachute jump.

Immunophenotype of normal vs. myeloma plasma cells: Toward antibody panel specifications for MRD detection in multiple myeloma.

In recent years, several studies on large series of multiple myeloma (MM) patients have demonstrated the clinical utility of flow cytometry monitoring of minimal residual disease (flow-MRD) in bone marrow (BM), for improved assessment of response to therapy and prognostication. However, disturbing levels of variability exist regarding the specific protocols and antibody panels used in individual laboratories. Overall, consensus exists about the utility of combined assessment of CD38 and CD138 for the identification of BM plasma cells (PC); in contrast, more heterogeneous lists of markers are used to further distinguish between normal/reactive PCs and myeloma PCs in the MRD settings. Among the later markers, CD19, CD45, CD27, and CD81, together with CD56, CD117, CD200, and CD307, have emerged as particularly informative; however, no single marker provides enough specificity for clear discrimination between clonal PCs and normal PCs. Accordingly, multivariate analyses of single PCs from large series of normal/reactive vs. myeloma BM samples have shown that combined assessment of CD138 and CD38, together with CD45, CD19, CD56, CD27, CD81, and CD117 would be ideally suited for MRD monitoring in virtually every MM patient. However, the specific antibody clones, fluorochrome conjugates and sources of the individual markers determines its optimal (vs. suboptimal or poor) performance in an eight-color staining. Assessment of clonality, via additional cytoplasmic immunoglobulin (CyIg) κ vs. CyIgλ evaluation, may contribute to further establish the normal/reactive vs. clonal nature of small suspicious PC populations at high sensitivity levels, provided that enough cells are evaluated.