Frailty and risk of complications in head and neck oncologic surgery. Systematic review and dose-response meta-analysis.

BACKGROUND: There is emerging evidence that frail individuals present a decreased physiological reserve, decreased ability to maintain homeostasis, and increased vulnerability to stressors. The concept of frailty has become increasingly recognized as a valuable measure in oncological surgical patients, including those with head and neck cancer. Preoperative screening for frailty may provide an individualized risk assessment that can be used by an interdisciplinary team for preoperative counseling and to improve outcomes. The aim of this meta-analysis was to evaluate the relationship between frailty and the risk of major postoperative complications in frail individuals submitted to head and neck oncologic surgery. MATERIAL AND METHODS: PubMed, SCOPUS, Web of Science, Google Scholar and OpenThesis were systematically searched to identify studies that evaluated the risk of major postoperative complications in frail individuals undergoing head and neck oncologic surgery. The search was performed on August 31, 2020, without language or date restrictions. Two independent investigators screened the searched studies based on each paper's title and abstract. Relevant studies were read in full and selected according to the eligibility criteria. Frailty was assessed by modified Frailty Index (mFI-11) and major postoperative complications were measured by the Clavien-Dindo classification. We performed a categorical and dose-response meta-analysis using a random-effects model to evaluate the association between frailty and the risk of major postoperative complications in patients submitted to head and neck oncologic surgery. The results of the meta-analysis were expressed as relative risk (RR) and 95% confidence interval (95% CI). The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). RESULTS: Four studies (9,947 patients) were included in this systematic review and meta-analysis. Frail patients presented an increased risk of life-threatening complications requiring intensive care unit (ICU) admission (RR = 4.67; 95% CI 1.54-14.10) and 30-day mortality (RR = 8.10; 95% CI 2.30-28.57) compared to non-frail patients. We found evidence of dose-response trend between mFI-11 and major postoperative complications. CONCLUSIONS: Higher frailty scores are associated with a significant increase in ICU-level complications and 30-day mortality after head and neck oncologic surgery.

Physical approach for a quantitative analysis of the phytosterols in free phytosterol-oil blends by X-ray Rietveld method.

This study investigates and compares the thermal phase transition and crystallization characteristics of a commercial food grade free phytosterol blend (FP) with a stigmasterol analytical standard (SS), the FP behavior in a food model system after its addition to high oleic sunflower oil (HOSO). The properties of the FP:HOSO blends were studied by differential scanning calorimetry, solid content, crystal morphology, and X-ray diffraction (XRD) measurements. The Rietveld method (RM) was applied associated with the XRD measurements to support phase analysis and the study of crystallinity degree. The materials were also characterized by means of chemical composition, such as fatty acids and triacylglycerol profiles, for HOSO, and phytosterol profile, for FP. Regarding phase behavior and crystallinity properties, FP has very similar characteristics to SS. The thermal behavior of FP:HOSO blends has two characteristic peaks, one from FP and the other from HOSO. The similarity reported in the literature between the diffraction pattern of FP and pure phytosterols is a positive characteristic for FP. A high FP concentration resulted in high supersaturation and thus the formation of small crystals. The incorporation of HOSO reduced of the large agglomeration of FP crystals and the dispersion crystalline aggregates (spherulites) of FP crystals. The application of RM in FP:HOSO blends to quantify the crystalline and amorphous phases was successfully used. The application has provided the expected value for these phases, according to the same experimental mass ratio of the blends, thereby validating the applicability of this approach in this type of material.

Genetic parameters and prediction of genotypic values for root quality traits in cassava using REML/BLUP.

The aim of this study was to estimate the genetic parameters and predict the genotypic values of root quality traits in cassava (Manihot esculenta Crantz) using restricted maximum likelihood (REML) and best linear unbiased prediction (BLUP). A total of 471 cassava accessions were evaluated over two years of cultivation. The evaluated traits included amylose content (AML), root dry matter (DMC), cyanogenic compounds (CyC), and starch yield (StYi). Estimates of the individual broad-sense heritability of AML were low (hg(2) = 0.07 ± 0.02), medium for StYi and DMC, and high for CyC. The heritability of AML was substantially improved based on mean of accessions (hm(2) = 0.28), indicating that some strategies such as increasing the number of repetitions can be used to increase the selective efficiency. In general, the observed genotypic values were very close to the predicted average of the improved population, most likely due to the high accuracy (>0.90), especially for DMC, CyC, and StYi. Gains via selection of the 30 best genotypes for each trait were 4.8 and 3.2% for an increase and decrease for AML, respectively, an increase of 10.75 and 74.62% for DMC for StYi, respectively, and a decrease of 89.60% for CyC in relation to the overall mean of the genotypic values. Genotypic correlations between the quality traits of the cassava roots collected were generally favorable, although they were low in magnitude. The REML/BLUP method was adequate for estimating genetic parameters and predicting the genotypic values, making it useful for cassava breeding.

Eletrocardiografia contínua (Holter) em cães saudáveis submetidos a diferentes exercícios físicos / Ambulatory electrocardiography (Holter) in healthy dogs submitted to different physical exercises

O presente trabalho teve como objetivo avaliar os efeitos de diferentes cargas de exercícios físicos no comportamento da frequência e do ritmo cardíaco de cães saudáveis, ao longo das 24 horas de gravação Holter. Utilizaram-se 23 cães, sem restrição de sexo, idade ou raça, dos quais 15 foram submetidos a atividades físicas e pertenciam ao grupo controle. Os resultados mostraram alterações na frequência cardíaca durante as atividades propostas, em que se alcançaram 174±27bpm durante a caminhada leve, 148±30 durante a atividade com bola e 165±26 durante o Cooper. Ademais, observaram-se arritmias, incluindo bloqueios atrioventriculares e extrassístoles e maior número e duração de pausas (até 5s) em repouso, além de uma menor variação na frequência cardíaca (FC) durante o período de sono dos animais do grupo experimental. Esses eventos não foram observados no grupo controle, o que sugere que o exercício físico extenuante interfere na modulação autonômica do coração, podendo predispor a arritmias importantes.

This study aimed to evaluate the effects of different loads of exercises on the heart rate behavior and rhythm in healthy dogs, over the 24-hour Holter recording. Twenty-three dogs were used without gender, age or breed restriction, and 15 animals were submitted to physical activities and 8 were used as control group. The results showed changes in heart rate during the proposed activities, with 174±27 bpm while walking, 148±30 during ball activity and 165±26 during Cooper. Moreover, arrhythmias were observed, including atrioventricular blocks and premature complexes and a larger number and duration of pauses (up to 5 sec) at rest, and provided a smaller variation in the HR during the sleep period of animals from the experimental group. These events were not observed in the control group, suggesting that strenuous physical exercise affects the autonomic modulation of the heart, and may lead to important arrhythmias.

Neonatal morphine administration leads to changes in hippocampal BDNF levels and antioxidant enzyme activity in the adult life of rats.

It is know that repeated exposure to opiates impairs spatial learning and memory and that the hippocampus has important neuromodulatory effects after drug exposure and withdrawal symptoms. Thus, the aim of this investigation was to assess hippocampal levels of BDNF, oxidative stress markers associated with cell viability, and TNF-α in the short, medium and long term after repeated morphine treatment in early life. Newborn male Wistar rats received subcutaneous injections of morphine (morphine group) or saline (control group), 5 µg in the mid-scapular area, starting on postnatal day 8 (P8), once daily for 7 days, and neurochemical parameters were assessed in the hippocampus on postnatal days 16 (P16), 30 (P30), and 60 (P60). For the first time, we observed that morphine treatment in early life modulates BDNF levels in the medium and long term and also modulates superoxide dismutase activity in the long term. In addition, it was observed effect of treatment and age in TNF-α levels, and no effects in lactate dehydrogenase levels, or cell viability. These findings show that repeated morphine treatment in the neonatal period can lead to long-lasting neurochemical changes in the hippocampus of male rats, and indicate the importance of cellular and intracellular adaptations in the hippocampus after early-life opioid exposure to tolerance, withdrawal and addiction.

1D and 3D anthropometric data application on public transport vehicle layout and on oil and gas laboratories work environment design.

The goal of this paper is to present 1D and 3D anthropometric data applied to two distinct design situations: one related to the interior layout of a public transport vehicle and another one related to oil and gas laboratories work environment design. On this study, the 1D anthropometric data were extracted from the Brazilian anthropometric database developed by INT and the 3D anthropometric data were obtained using a Cyberware 3D whole body scanner. A second purpose of this paper is to present the 3D human scanning data as a tool that can help designers on decision making.