Evaluación de afección en calidad de vida en adultos con dermatitis atópica / Assessment of quality of life illness in adult patients with atopic dermatitis

Introducción: la dermatitis atópica (DA) es una enfermedad con repercusión en la calidad de vida (CV) del paciente. Para la evaluación de la gravedad clínica de la enfermedad se han diseñado diversas herramientas como el Eczema Area and Severity Index (EASI), mientras que para la evaluación de la CV se han creado instrumentos específico, como el Dermatology Life Quality Index (DLQI) y el Quality of Life Index for Atopic Dermatitis (QoLIAD). Objetivo: definir cuál es la mejor herramienta para evaluar la afección a la CV de pacientes adultos con DA, en relación con el EASI. Material y métodos: se seleccionaron pacientes con DA (> 18 años) que aceptaran responder a los cuestionarios DLQI y QoLIAD, así como tener una exploración dermatológica reportada según el EASI. Se ajustaron tres modelos de regresión lineal simple para poder cuantificar la asociación entre el EASI con el DLQI y el QoLIAD. Un valor de p < 0.05, se consideró de significancia estadística. El modelo de afección a CV con el valor más alto de pseudo R2, se consideró como el que tuvo mayor asociación con EASI. Resultados: se captaron en total 72 pacientes. Los modelos de regresión cuantílica simple revelaron un coeficiente de regresión de 0.243 para DLQI (p = 0.002) y 0.252 para QoLIAD (p = 0.003). Los valores de pseudo R2 fueron de 0.15 para DLQI y 0.10 para QoLIAD, por lo que el DLQI tuvo una mayor correlación con el EASI. Conclusiones: el DLQI resultó ser el mejor instrumento para evaluar la afección a la CV en pacientes adultos con DA.

Background: Atopic dermatitis (AD) is a disease with an im- pact on the patient's quality of life (QoL). Several tools have been designed to assess the clinical severity of the disease, such as the Eczema Area and Severity Index (EASI), while specific instruments have been created to assess QoL, such as the Dermatology Life Quality Index (DLQI) and the Quality of Life Index for Atopic Dermatitis (QoLIAD). Objective: To define which tool is the best to assess the QoL condition of adult patients with AD in relation to the EASI. Material and methods: Patients with AD (> 18 years old) were selected who agreed to complete the DLQI and QoLIAD questionnaires, as well as to have a dermatologic examination reported according to the EASI. Three simple linear regression models were fitted in order to quantify the association between EASI with DLQI and QoLIAD. A value of p < 0.05 was considered statistically significant. The CV condition model with the highest pseudo R2 value was considered to have the strongest association with EASI. Results: A total of 72 patients were included. Simple quantile regression models revealed a regression coefficient of 0.243 for DLQI (p = 0.002) and 0.252 for QoLIAD (p = 0.003). The pseudo R2 values were 0.15 for DLQI and 0.10 for QoLIAD, so DLQI had a higher correlation with EASI. Conclusions: DLQI proved to be the best instrument to assess CV impairment in adult patients with AD.

Enhanced ethanol production at commercial scale from molasses using high gravity technology by mutant S. cerevisiae

Abstract Very high gravity (VHG) technology was employed on industrial scale to produce ethanol from molasses (fermented) as well as by-products formation estimation. The effect of different Brix° (32, 36 and 40) air-flow rates (0.00, 0.20, 0.40, and 0.60 vvm) was studied on ethanol production. The maximum ethanol production was recorded to be 12.2% (v/v) at 40 Brix° with 0.2 vvm air-flow rate. At optimum level aeration and 40 Brix° VHG, the residual sugar level was recorded in the range of 12.5-18.5 g/L, whereas the viable cell count remained constant up to 50 h of fermentation and dry matter production increased with fermentation time. Both water and steam consumption reduced significantly under optimum conditions of Brix° and aeration rate with compromising the ethanol production. Results revealed VHG with continuous air flow is viable technique to reduce the ethanol production cost form molasses at commercial scale.

Enhanced ethanol production at commercial scale from molasses using high gravity technology by mutant S. cerevisiae.

Very high gravity (VHG) technology was employed on industrial scale to produce ethanol from molasses (fermented) as well as by-products formation estimation. The effect of different Brix° (32, 36 and 40) air-flow rates (0.00, 0.20, 0.40, and 0.60vvm) was studied on ethanol production. The maximum ethanol production was recorded to be 12.2% (v/v) at 40 Brix° with 0.2vvm air-flow rate. At optimum level aeration and 40 Brix° VHG, the residual sugar level was recorded in the range of 12.5-18.5g/L, whereas the viable cell count remained constant up to 50h of fermentation and dry matter production increased with fermentation time. Both water and steam consumption reduced significantly under optimum conditions of Brix° and aeration rate with compromising the ethanol production. Results revealed VHG with continuous air flow is viable technique to reduce the ethanol production cost form molasses at commercial scale.

A low-cost intracellular delivery system based on microbubble and high gravity field.

In this paper, we developed a low-cost intracellular delivery system based on microbubble and high gravity field. We successfully delivered FITC-Dextran (40kD) into hard-to-deliver THP-1 cells. The results showed that our method achieved high delivery efficiency up to 80%. It was found that the delivery efficiency and cell viability were closely related to the centrifuge speed. We speculated that the burst of microbubbles causes transient pore opening thus increasing the chance of biomolecules entering cells. This fast, low-cost and easy-to-operate protocol is very promising for delivering therapeutic genes and drugs into any cells which do not actively take up extracellular materials. This method is most effective for in-vitro delivery, but after delivery, treated cells might be injected back to human for in-vivo imaging.

The use of dried spent yeast as a low-cost nitrogen supplement in ethanol fermentation from sweet sorghum juice under very high gravity conditions

Dried spent yeast (DSY) was used as a low-cost nitrogen supplement for ethanol fermentation from sweet sorghum juice under very high gravity (VHG) conditions by Saccharomyces cerevisiae NP 01. The fermentation was carried out at 30ºC in a 5-litre bioreactor. The results showed that DSY promoted ethanol production efficiencies. The ethanol concentration (P), productivity (Qp) and yield (Yp/s) of the sterile juice (total sugar of 280 g l-1) supplemented with 8 g l-1 of DSY were not different from those supplemented with yeast extract and/or peptone at the same amount. The initial yeast cell concentration of 5 x 10(7) cells ml-1 was found to be optimal for scale-up ethanol production. In addition, an increase in sugar concentration in inoculum preparation medium (from 10 to 100 g l-1) improved the ability of the inoculum to produce ethanol under the VHG conditions. When S. cerevisiae NP 01 grown in the juice containing 100 g l-1 of total sugar was used as the inoculum for ethanol fermentation, the P, Qp and Yp/s obtained were 108.98 +/- 1.16 g l-1, 2.27 +/- 0.06 g l-1 h-1 and 0.47 +/- 0.01 g g-1, respectively. Similar results were also observed when the ethanol fermentation was scaled up to a 50-litre bioreactor under the same conditions. The cost of the sweet sorghum for ethanol production was US$ 0.63 per litre of ethanol. These results clearly indicate the high potential of using sweet sorghum juice supplemented with DSY under VHG fermentation for ethanol production in industrial applications.

New method of visual disturbances assessment in pilots during tests in the Polish human centrifuge.

OBJECTIVES: Visual disturbances are commonly accepted criteria for acceleration tolerance assessment. Researchers during centrifuge experiments use them as a safe criterion for cessation of acceleration exposure. Visual disturbances analysis is a non-invasive method of assessing retinal blood flow. Limitation of visual stimuli perception is a measure of physiological state of the experiment participants before hemodynamic changes, which reach a critical level manifested by G-induced loss of consciousness. Detection of these disturbances play an important role during the acceleration tolerance assessment. In this study, an attempt was made to answer the question on how many mistakes or incorrect reactions had to be identified to classify the ability of the pilot to fly on military jets. MATERIALS AND METHODS: A new computer-aided research apparatus of our own design was used to assess visual disturbances, being a criterion of +Gz tolerance. In the center of monitor screen, a line of 3 light points was projected. During the centrifuge test, green lateral lights randomly changed their shapes from circles to squares while central light, being a point of vision fixation, remained unchanged. To assess its efficacy, 14 volunteers participated in the tests with various stimuli exposure. The authors aimed at selecting parameters of stimuli and exposure so that the division of reactions presented in the table would correspond with the score scale appropriate for our goals. RESULTS: Preliminary tests showed that appropriately selected light intensity of the exposed stimuli enables the use of test results to assess the number of erroneous reactions, and consequently the level of pilots' concentration during centrifuge tests. CONCLUSIONS: It has been found that the chosen luminance range of the projected light points is correct as it allows to evaluate the reactions, which should be considered erroneous. Additionally, prolongation of the correct reaction time to the mean value of about 400 ms facilitates better differentiation of results. Proper results evaluation, depending on the number of errors, lack of reactions or prolonged reactions made the assessment easier with computer-aided methods.

Acceleration risk in student fighter pilots: preliminary analysis of a management program.

Despite advances in G-protection, F-16 student pilots continue to demonstrate G-performance inadequacies. The G-Risk Indicator Management (GRIM) Program was introduced at Luke Air Force Base in 2000 to facilitate early detection of G-related problems and to aid in the establishment of tailored ground training programs designed to enhance a student's performance under G. Assessment of anthropomorphic data, previous G-performance, anaerobic fitness, and centrifuge qualification scores comprise the initial assessment in the GRIM Program. Observations from these assessments are used to qualitatively determine the level of risk for the student. In the absence of any historical controls, no conclusions could be drawn with regards to the overall efficiency of the GRIM program. Significant differences were found between groups for anaerobic test scores, centrifuge scores, and gradebook comments. The results from this non-experimental study suggest the need for future studies to better determine the validity of G-risk indicators.

An electromyographic assessment of the anti-G straining maneuver.

BACKGROUND: The anti-G straining maneuver (AGSM), used by aircrew to enhance their +Gz tolerance and to reduce the potential risk of G-induced loss of consciousness, has been recognized as an effective technique. The purpose of this study was to establish an objective tool to evaluate the effectiveness of an aircrew member's AGSM. METHODS: There were 20 healthy subjects who participated in the study, including 8 senior aviation physiological trainers and 12 trainees. The former were familiar with the anti-G maneuver and had experienced high +Gz exposure, the latter had never been exposed to any high +Gz stress before the study. The analytic method of electromyography (EMG) was used to investigate the physical characteristics of the L-1 AGSM. RESULTS: Comparison of the EMG data from the two groups indicated that the mean duration of a breathing cycle of the trainer group was significantly longer than that of the trainee group (p < 0.001). The buccinator was the muscle that had the most rapid firing rate in both groups (p < 0.001). The trainer group had a significantly faster firing rate of the buccinator than the trainee group (p = 0.03). In addition, the trainee group performed the AGSM with a firing sequence of muscles that was different from that of the trainer group. CONCLUSIONS: An automated and quantitative system based on EMG can be used during AGSM training to augment or replace the current subjective evaluation of the trainee's performance.

Focused Assessment with Sonography for Trauma in weightlessness: a feasibility study.

BACKGROUND: The Focused Assessment with Sonography for Trauma (FAST) examines for fluid in gravitationally dependent regions. There is no prior experience with this technique in weightlessness, such as on the International Space Station, where sonography is currently the only diagnostic imaging tool. STUDY DESIGN: A ground-based (1 g) porcine model for sonography was developed. We examined both the feasibility and the comparative performance of the FAST examination in parabolic flight. Sonographic detection and fluid behavior were evaluated in four animals during alternating weightlessness (0 g) and hypergravity (1.8 g) periods. During flight, boluses of fluid were incrementally introduced into the peritoneal cavity. Standardized sonographic windows were recorded. Postflight, the video recordings were divided into 169 20-second segments for subsequent interpretation by 12 blinded ultrasonography experts. Reviewers first decided whether a video segment was of sufficient diagnostic quality to analyze (determinate). Determinate segments were then analyzed as containing or not containing fluid. A probit regression model compared the probability of a positive fluid diagnosis to actual fluid levels (0 to 500 mL) under both 0-g and 1.8-g conditions. RESULTS: The in-flight sonographers found real-time scanning and interpretation technically similar to that of terrestrial conditions, as long as restraint was maintained. On blinded review, 80% of the recorded ultrasound segments were considered determinate. The best sensitivity for diagnosis in 0 g was found to be from the subhepatic space, with probability of a positive fluid diagnosis ranging from 9% (no fluid) to 51% (500 mL fluid). CONCLUSIONS: The FAST examination is technically feasible in weightlessness, and merits operational consideration for clinical contingencies in space.

Resting energy expenditure of rats acclimated to hypergravity.

BACKGROUND: The use of centrifugation at 1 G has been advocated as a control condition during spaceflight and as a countermeasure to compensate for the adverse effects of spaceflight. Rodents are the primary animal model for the study of the effects of spaceflight and will be used in the evaluation of centrifugation as a countermeasure and means of control at 1 G during flight. HYPOTHESIS: The present study was designed to assess whether resting energy expenditure (EER) of male rats was increased in relation to the magnitude of the level of gravity to which the animals were exposed. The influence of body mass and age on resting energy expenditure (EER) of male rats (n = 42, age 40-400 d) was determined following 2 wk of acclimation to 1, 2.3, or 4.1 G. Hypergravity environments were created by centrifugation. Measurements were made at the gravity level to which the animal was acclimated and during the lights-on period. RESULTS: In rats matched for body mass (approximately 400 g), mean O2 consumption and CO2 production were higher (18% and 27%, respectively) in the 2.3- and 4.1 -G groups than controls. Mean respiratory exchange ratio (RER) increased from 0.80 to 0.87. EER was increased from 47 +/- 0.1 kcal x d(-1) at 1 G, to 57 +/- 1.5 and 58 +/- 2.2 kcal x d(-1) at 2.3 and 4.1 G, respectively. There was no difference in EER between the hypergravity groups. When age differences were considered, EER (kcal x kg(-1) x d(-1)) with increased gravity was 40% higher than at 1 G. The increase in EER was not proportional over gravity levels. CONCLUSION: Acclimation of rats to hypergravity increases their EER, dependent on body mass and age, and may alter substrate metabolism. The increase in EER was not related to the level of gravity increase.

[A model system for the assessment of the stability of eukaryotic genes and expressed proteins in extended space flight]. / Model'naia sistema dlia izucheniia stabil'nosti éukarioticheskikh genov i ékspressiruemykh belkov v usloviiakh dlitel'nogo kosmicheskogo poleta.

Evidence was obtained that the changed gravity, tension profiles of the magnetic fields inside the orbital station and other spaceflight factors (SFF) substantially influence the cell genome and synthesis of recombinant proteins. The authors proposed a technique of fixation of possible alterations in genes and expressed recombinant proteins in strains-producers of human alpha-interferon: HuIFN-alpha 2b, HuIFN-alpha 8a, HuIFN-alpha 10a, and HuIFN-alpha 14a. Spaceflight factors were simulated by way of gamma-irradiation at 10 Gy and 50 Gy by a cobalt unit, and centrifugation of samples at 10 g and 50 g. Cultivation of the strains-producers during the SFF simulation yielded HuIFN-alpha proteins with altered functional characteristics. Following exposure to simulated SFF, strains-producers expressed HuIFN-alpha that preserved a high titre of antiviral activity (AVA) but suppressed the antiproliferative activity (APA) inferring some structural/functional shifts in the HuIFN-alpha molecule due to, presumably, mutations in the active center responsible for APA. Determination of species specificity of the HuIFN-alpha recombinant proteins following exposure to SFF revealed dissociation of cross-AVA in homologous and heterologous cell cultures which can be also attributed to the structural/functional shifts in the HuIFN-alpha molecule. These changes can be localized in the receptor cluster of molecule or consequent to modification of the center defining HuIFN-alpha species specificity. The proposed simulation system allows fixation of shifts in the HuIFN-alpha structural/functional characteristics and investigations of the stability of eucaryotic genes in long-term space flights.

Laboratory outreach: student assessment of flow cytometer fluidics in zero gravity.

Due to the the clinical utility of the flow cytometer, the National Aeronautics and Space Administration (NASA) is interested in the design of a space flight-compatible cytometer for use on long-duration space missions. Because fluid behavior is altered dramatically during space flight, it was deemed necessary to validate the principles of hydrodynamic focusing and laminar flow (cytometer fluidics) in a true microgravity environment. An experiment to validate these properties was conducted by 12 students from Sweetwater High School (Sweetwater, TX) participating in the NASA Reduced Gravity Student Flight Opportunity, Class of 2000. This program allows high school students to gain scientific experience by conducting an experiment on the NASA KC-135 zero gravity laboratory aircraft. The KC-135 creates actual zero-gravity conditions in 30-second intervals by flying a highly inclined parabolic flight path. The experiment was designed by their mentor in the program, the Johnson Space Center's flow cytometrist Brian Crucian, PhD, MT(ASCP). The students performed the experiment, with the mentor, onboard the NASA zero-gravity research aircraft in April 2000.

Assessment of two methods to reduce simulated +Gz-induced arm pain using a non-centrifuge model.

Complaints of +Gz-induced arm pain have been expressed by centrifuge subjects and, to a lesser degree, by high performance fighter pilots, usually when the control stick and throttle are positioned below heart level; the pain may be higher during pressure breathing for +Gz protection. Elevated transmural pressure and overdistension of the blood vessels in the arms have been suggested as causal factors. An earlier-developed non-centrifuge model was used to provoke arm pain similar to that induced by +Gz exposure. Eleven healthy subjects placed inside a hyperbaric chamber with an arm externalized through a sealed opening. They were exposed to chamber pressures at 75, 100 and 125 mmHg fitted with elastic bandage of the arm, or a localized pressure of 50 mmHg applied to the vessels of the upper arm or were provided no protection (control). Arm pain was estimated using a modified Borg scale. The sizes of the ulnar, radial and interosseous arteries, and corresponding veins, at the elbow level were measured using a sonographic imaging system. No statistically significant differences in pain were detected comparing control to proposed (counteracting) devices. There were no statistical differences in arm arterial or venous vessel size with the different devices at the different pressures. Thus, the devices tested did not show any protection against the provoked arm pain.

Ballistocraft: a novel facility for microgravity research.

One of ESA's aims is to provide the microgravity research community with various microgravity exposure facilities. Those facilities include drop towers, sounding rockets, and parabolic flights on board aircraft, in addition to orbital spacecraft. Microgravity flights are usually achieved using large aircraft like the French 'Caravelle' that offer a large payload volume and where a person can be present to perform the experiments and to participate as a human test-subject. However, the microgravity community is also very interested in a flexible, complementary facility that would allow frequent and repetitive exposure to microgravity for a laboratory-type of payload. ESA has therefore undertaken a study of the potential of using a 'ballistocraft', a small unmanned aircraft, to provide a low-cost facility for short-duration (30-40 seconds) microgravity experimentation. Fokker Space & Systems performed the study under an ESA contract, supported by Dutch national funding. To assess the ballistocraft, a simple breadboard of the facility was built and flight tests were performed. The ability of the on-board controller to achieve automated parabolic flights was demonstrated, and the performance of the controller in one-g level flights, and in flights with both zero-g and partial-g setpoints, was evaluated. The partial-g flights are a unique and valuable feature of the facility.