Unconventional Spin Relaxation Involving Localized Vibrational Modes in Ho Single-Atom Magnets.

We investigate the spin relaxation of Ho single atom magnets on MgO/Ag(100) as a function of temperature and magnetic field. We find that the spin relaxation is thermally activated at low field, while it remains larger than 1000 s up to 30 K and 8 T. This behavior contrasts with that of single molecule magnets and bulk paramagnetic impurities, which relax faster at high field. Combining our results with density functional theory, we rationalize this unconventional behavior by showing that local vibrations activate a two-phonon Raman process with a relaxation rate that peaks near zero field and is suppressed at high field. Our work shows the importance of these excitations in the relaxation of axially coordinated magnetic atoms.

Medical and socio-occupational predictive factors of psychological distress 5 years after a road accident: a prospective study.

PURPOSE: Psychosocial consequences of road accidents are a major clinical problem that incurs significant social, occupational, and economic costs. The purpose of our study was to assess medical and socio-occupational factors of psychological distress in the severely injured 5 years after a road accident. METHODS: A total of 691 of the 1168 subjects enrolled in a prospective cohort of road accident casualties (ESPARR cohort) responded to both standardized follow-up questionnaires at 1 and 5 years, assessing socio-occupational characteristics, physical and psychological sequelae, pain and perceived quality of life. RESULTS: One quarter of participants exhibited psychological distress 5 years after the road accident; most of whom are women, with low educational level, and suffering from spinal lesions. After adjusting for several factors, psychological distress at 5 years was predicted by female gender and low educational level, and by several other factors observed 1 year after the road accident: poor self-reported quality of life, attention deficit and symptoms of anxiety. CONCLUSIONS: Early-stage improvement in the screening and care of mental disorders in road accident casualties should help to reduce long-term psychological distress.

Academic and professional paths of narcoleptic patients: the Narcowork study.

OBJECTIVE/BACKGROUND: To study educational and professional pathways of narcoleptic patients and examine demographic, disease-related and environmental factors associated with a better academic and professional prognosis. PATIENTS/METHODS: In sum, 69 narcoleptic patients (51 narcolepsy type 1 and 18 narcolepsy type 2, age 42.5 ± 18.2 years) were enrolled in this pilot monocentric cross-sectional study with a comparison group (80 age- and sex-matched controls) between October 2017 and July 2018 in Lyon Center for Sleep Medicine. They completed questionnaires about their academic and professional trajectories and specific scales of quality of life (EuroQol quality of life scale EQ-5D-3L), depression (beck depression inventory, BDI), sleepiness (Epworth Sleepiness Scale, ESS) and narcoleptic symptoms severity (narcolepsy severity scale, NSS). RESULTS: No difference in grade repetition or final obtained diploma was observed between patients and controls, but patients evaluated their academic curricula as more difficult (45.5% vs 16.9%, p = 0.0007), complained for more attentional deficits (75% vs 22.1%, p < 0.0001), and had needed more educational reorientation (28.6% vs 9.9%, p = 0.01). Even if no difference was observed in occupational category and professional status, patients expressed significantly less satisfaction about their work. Patients had more signs of depression [OR severe depression = 4.4 (1.6-12.6), p = 0.02] and their quality of life was significantly decreased (67.3 ± 18.4 vs 80.6 ± 13.2, p = 0.0007) as compared to controls. Multivariate analysis showed that a more favorable professional career was associated with a better quality of life. CONCLUSIONS: Educational and professional pathways do not seem to be significantly impaired in narcoleptic patients, but their experience and quality of life are affected. These findings may allow to reassure patients and should lead to a more comprehensive management of the disease. CLINICAL TRIAL REGISTRATION: Narcowork, https://clinicaltrials.gov/ct2/show/NCT03173378, N° NCT03173378.

Working conditions and risk exposure of employees whose occupations require driving on public roads - Factorial analysis and classification.

INTRODUCTION: Several studies of the working conditions of drivers, and in particular on their pace of work, have enabled a better understanding of the risk factors for road accidents that occur during work. However, few studies are available on the risk exposure and working conditions of employees whose occupations involve driving. The purpose of this paper is to identify the different groups of employees occupationally exposed to road risk and to classify them according to working conditions. METHODOLOGY: A Multiple Correspondence Analysis (MCA) was implemented on the 41,727 individuals from the SUMER 2010 survey (Medical Monitoring of Occupational Risk Exposure: SUrveillance Médicale des Expositions aux Risques professionnels) and for 45 variables about working conditions. The analysis used 5 categories of weekly driving exposure as a supplementary variable (variable which is not used to perform the MCA): Non-exposure; Exposed <2 h; Exposed 2-10 hours; Exposed 10-20 hours; and Exposed >20 h. The results of the MCA were used to construct an ascending hierarchical classification. RESULTS: The first factorial axis differentiates between conventional and unconventional work schedules. Axis 2 differentiates modalities corresponding to the working hours of the most recent working week. The third axis chiefly contrasts persons who have rules to follow with those who have none. An ascending hierarchical classification distinguishes 10 clusters of individuals according to working conditions. Four clusters of employees were excessively exposed to occupational driving. Clusters also have distinct demographic, occupational and psychosocial characteristics. CONCLUSION: Analysis of data from the SUMER survey confirms that employees exposed to road risk are particularly affected by atypical work time characteristics, but can be found in all activity sectors and in all types of job.

Multistable Free States of an Active Particle from a Coherent Memory Dynamics.

We investigate the dynamics of a deterministic self-propelled particle endowed with coherent memory. We evidence experimentally and numerically that it exhibits several stable free states. The system is composed of a self-propelled drop bouncing on a vibrated liquid driven by the waves it emits at each bounce. This object possesses a propulsion memory resulting from the coherent interference of the waves accumulated along its path. We investigate here the transitory regime of the buildup of the dynamics which leads to velocity modulations. Experiments and numerical simulations enable us to explore unchartered areas of the phase space and reveal the existence of a self-sustained oscillatory regime. Finally, we show the coexistence of several free states. This feature emerges both from the spatiotemporal nonlocality of this path memory dynamics as well as the wave nature of the driving mechanism.

Benefit of continuous positive airway pressure on work quality in patients with severe obstructive sleep apnea.

BACKGROUND: The objective of this prospective study was to assess the effect of CPAP therapy on job productivity and work quality for patients with severe obstructive sleep apnea (OSA). METHODS: A convenience sample of patients diagnosed with severe OSA using polysomnography or polygraphy and with a therapeutic indication for CPAP was enrolled in our study. Patients completed two self-administered questionnaires: the first before CPAP therapy and the second during the first 6 months after CPAP treatment. OSA symptoms were evaluated through self-administered questionnaires assessing potential effects on occupational activity: excessive daytime sleepiness was rated by the Epworth Sleepiness Scale (ESS), emotional status was rated by the Hospital Anxiety and Depression (HAD) scale, work quality was rated by the Work Role Functioning Questionnaire (WRFQ). RESULTS: Forty patients (30 men, mean age 47.3 ± 8.3, mean BMI 31.6 ± 7.4, mean apnea-hypopnea index 51.8 ± 16.3) showed a beneficial effect of CPAP therapy on ESS score (mean 11.6 to 8.2, p < 0.0001), the anxiety dimension (mean 57.5% to 20%, p = 0.0002), and the overall anxiety-depressive score (mean 50% to 22.5%, p = 0.0006). Mean WRFQ scores were significantly improved in the second questionnaire for the dimensions of timetable requirements (69.3% to 83.5%, p < 0.0001), productivity requirements (71.4% to 82.2%, p < 0.0001), mental requirements (72.0% to 84.3%, p < 0.0001), and social requirements (82.6% to 91.4%, p < 0.003). CONCLUSIONS: We observed that adherence to CPAP therapy for patients with severe OSA mitigates the impact of symptoms on work including excessive daytime sleepiness, impairment of work ability, and anxiety and depressive disorders.

Indicators of long-term return to work after severe traumatic brain injury: A cohort study.

BACKGROUND: Return to work (RTW) is a major objective in the rehabilitation of individuals with severe traumatic brain injury (TBI). Implications for long-term occupational integration (beyond 5 years) have rarely been studied. OBJECTIVE: The objective was to assess long-term RTW and the associated factors after severe TBI. MATERIAL AND METHODS: Retrospective analysis of a cohort of individuals 16 to 60 years old admitted to hospital after severe TBI from 2005 to 2009 and followed prospectively. Medical and occupational data were collected from medical files and by systematic telephone interview to assess outcome at a minimum of 6 years post-trauma. Factors associated with RTW were investigated by multivariable regression analysis, estimating prevalence ratios (PRs) and 95% confidence intervals (CIs). A proportional hazards model was used to study RTW delay, estimating hazard ratios (HRs). RESULTS: Among the 91 individuals included (mean [SD] age 28.5 [11.3] years; 79% male), 63.7% returned to work after a mean of about 20 months, and 57.1% were still working at the time of the survey. Factors significantly associated with RTW on multivariable analysis were higher educational level (adjusted PR, 1.53; 95% CI, 1.15 to 2.03), absence of motor disability (adjusted PR, 1.82; 1.12 to 2.95) and behavioural disorder (adjusted PR, 1.26; 1.01 to 1.60), as well as disabled worker status (adjusted PR, 1.26; 1.01 to 1.60) (likelihood of the multivariate analysis model 53.1). Delayed RTW was associated with health insurance payments (adjusted HR, 0.40; 95% CI, 0.22 to 0.71), motor disability (adjusted HR, 0.34; 0.15 to 0.76), low educational level (adjusted HR, 2.20; 1.06 to 4.56) and moderate disability on the Extended Glasgow Outcome Scale (adjusted HR, 0.49; 0.27 to 0.91) (likelihood of the multivariate analysis model 335.5). CONCLUSION: Individuals with the most severe TBI are able to RTW and remain in work. This study highlights the multiple determinants involved in RTW and the role of socioenvironmental factors.

Road casualties in work-related and private contexts: occupational medical impact. Results from the ESPARR cohort.

BACKGROUND: Road accidents may impact victims' physical and/or mental health and socio-occupational life, notably including return to work. OBJECTIVES: To assess whether the occupational medical consequences sustained by subjects injured in road accidents occurring in a work-related context differ from those associated with private accidents. METHODS: 778 adults who were in work or occupational training at the time of their accident were included. Two groups were distinguished: 354 (45.5%) injured in road accidents occurring in a work-related context (commuting or on duty) and 424 (54.5%) injured in a private accident. The groups were compared on medical and occupational factors assessed on prospective follow-up at 6 months and 1 and 3 years. Multivariate analysis explored for factors associated at 6 months and 1 year with sick leave following the accident and duration of sick leave. RESULTS: There were no significant differences between groups for demographic data apart from a slightly higher injury severity in private accidents (32.5% of private accidents with MAIS3+(Maximum Abbreviated Injury Scale greater or equal to 3) vs. 23.7% for work-related accidents, p = 0.007). Victims of work-related accidents were more often on sick leave (OR = 1.8; 95% CI, 1.1-2.9). Although the length of sick leave is higher for work-related accidents that for private accidents, multivariate analysis showed that the injury severity and the post-traumatic stress disorder (PTSD) are significant factors to explain the time to return to work. There were no significant differences according to occupational impact during follow-up, notably including sick-leave duration, number of victims returning to work within 3 years and number of victims out of work due to incapacity. CONCLUSIONS: In the ESPARR (follow-up study of a road-accident population in the Rhône administrative county: Etude de Suivi d'une Population d'Accidentés de la Route dans le Rhône) cohort, the fact that a road accident occurred in a work-related context did not affect the occupational consequences.

Magnetic bistability of a TbPc2 submonolayer on a graphene/SiC(0001) conductive electrode.

The alteration of the properties of single-molecule magnets (SMMs) due to the interaction with metallic electrodes is detrimental to their employment in spintronic devices. Conversely, herein we show that the terbium(iii) bis-phthalocyaninato complex, TbPc2, maintains its SMM behavior up to 9 K on a graphene/SiC(0001) substrate, making this alternative conductive layer highly promising for molecular spintronic applications.

Probing magnetic coupling between LnPc2 (Ln = Tb, Er) molecules and the graphene/Ni (111) substrate with and without Au-intercalation: role of the dipolar field.

Lanthanides (Ln) bis-phthalocyanine (Pc), the so-called LnPc2double decker, are a promising class of molecules with a well-defined magnetic anisotropy. In this work, we investigate the magnetic properties of LnPc2 molecules UHV-deposited on a graphene/Ni(111) substrate and how they modify when an Au layer is intercalated between Ni and graphene. X-ray absorption spectroscopy (XAS), and linear and magnetic circular dichroism (XLD and XMCD) were used to characterize the systems and probe the magnetic coupling between LnPc2 molecules and the Ni substrate through graphene, both gold-intercalated and not. Two types of LnPc2 molecules (Ln = Tb, Er) with a different magnetic anisotropy (easy-axis for Tb, easy-plane for Er) were considered. XMCD shows an antiferromagnetic coupling between Ln and Ni(111) even in the presence of the graphene interlayer. Au intercalation causes the vanishing of the interaction between Tb and Ni(111). In contrast, in the case of ErPc2, we found that the gold intercalation does not perturb the magnetic coupling. These results, combined with the magnetic anisotropy of the systems, suggest the possible importance of the magnetic dipolar field contribution for determining the magnetic behaviour.

Factors associated with non-return to work in the severely injured victims 3 years after a road accident: A prospective study.

Road accidents may impact victims' physical and/or mental health and socio-occupational life, particularly the capacity to return to work. The purpose of our study is to assess modifiable medical and socio-occupational factors of non-return to work in the severely injured 3 years after a road accident. Among1,168 road accidents casualties in the Rhône administrative Département of France followed for five years, 141 of the 222 severely injured (Maximal Abbreviated Injury Scale ≥ 3) aged more than 16 years who were in work at the time of the accident, reported whether they had returned to work in the 3 years following the accident. The subgroups of those who had (n=113) and had not returned to work (n=28) were compared for socio-occupational (gender, age, educational level, marital status, socio-occupational group) accident-related medical factors (type of road user, type of journey, responsibility in the accident, initial care) and post-accident medical factors (pain intensity, post-traumatic stress disorder, physical sequelae, quality of life) by using standardized tools. Severity of initial head, face and lower-limb injury, intense persistent pain, post-traumatic stress disorder, poor self-assessed quality of life and health status at 3 years were associated with non-return to work on univariate analysis. On multivariate analysis, severity of initial head and lower-limb injury, intense persistent pain at 3 years and post-traumatic stress disorder were significantly associated with non-return to work 3 years following severe road-accident injury. Post-traumatic stress disorder and chronic pain were essential modifiable medical determinants of non-return to work in the severely injured after a road accident: early adapted management could promote return to work in the severely injured. Improve early adapted treatment of pain and PTSD in the rehabilitation team should help the severely injured return to work following a road accident.

Adherence to capecitabine in preoperative treatment of stage II and III rectal cancer: do we need to worry?

BACKGROUND: Preoperative oral capecitabine plus radiotherapy has been progressively adopted in oncology units to provide more convenient care to patients with rectal cancer, but little is known about adherence to this therapy. PATIENTS AND METHODS: Prospective, multicentre observational study in six hospitals in metropolitan Barcelona (Spain), in patients with stage II and III rectal cancer. Assessment of adherence was based on the medical report in the clinical history, a patient questionnaire and a pill count in the pharmacy service upon finalization of treatment. Patients were considered adherent if they had taken 80%-110% of the prescribed treatment. We evaluated clinical variables, adverse effects, anxiety and depression (using the hospital anxiety depression scale [HADS]), and quality of life (EORTC QLQ-30). We analysed adherence-associated variables using a logistic regression model and concordance between adherence measures by means of the modified Kappa index. RESULTS: We included 119 participants. Adherence measures showed little concordance between the assessment methods used: adherence was 100% according to the clinical history, 83.2% according to self-report and 67.9% according to the pill count. In the multivariable analysis, the most relevant variable associated with non-adherence was anxiety prior to treatment (adjusted odds ratio [ORa] 6.96, 95% confidence interval [CI] 1.48-32.7). We did not observe any relevant association between adherence and clinical variables and baseline quality of life parameters. CONCLUSIONS: Adherence to short-term oral neoadjuvant treatment in rectal cancer may be a clinical problem, and it should be acknowledged and systematically evaluated by clinicians during treatment. The limited concordance between different measures of adherence highlights the challenges in monitoring it and the need to use different approaches to assess its impact in clinical practice.

Wave-Based Turing Machine: Time Reversal and Information Erasing.

The investigation of dynamical systems has revealed a deep-rooted difference between waves and objects regarding temporal reversibility and particlelike objects. In nondissipative chaos, the dynamic of waves always remains time reversible, unlike that of particles. Here, we explore the dynamics of a wave-particle entity. It consists in a drop bouncing on a vibrated liquid bath, self-propelled and piloted by the surface waves it generates. This walker, in which there is an information exchange between the particle and the wave, can be analyzed in terms of a Turing machine with waves as the information repository. The experiments reveal that in this system, the drop can read information backwards while erasing it. The drop can thus backtrack on its previous trajectory. A transient temporal reversibility, restricted to the drop motion, is obtained in spite of the system being both dissipative and chaotic.

The high-field magnet endstation for X-ray magnetic dichroism experiments at ESRF soft X-ray beamline ID32.

A new high-field magnet endstation for X-ray magnetic dichroism experiments has been installed and commissioned at the ESRF soft X-ray beamline ID32. The magnet consists of two split-pairs of superconducting coils which can generate up to 9 T along the beam and up to 4 T orthogonal to the beam. It is connected to a cluster of ultra-high-vacuum chambers that offer a comprehensive set of surface preparation and characterization techniques. The endstation and the beam properties have been designed to provide optimum experimental conditions for X-ray magnetic linear and circular dichroism experiments in the soft X-ray range between 400 and 1600 eV photon energy. User operation started in November 2014.

Impaired mental well-being and psychosocial risk: a cross-sectional study in female nursing home direct staff.

OBJECTIVES: The present study sought to quantify the impaired mental well-being and psychosocial stress experienced by nursing home staff and to determine the relationship between impaired mental well-being assessed on the 12-item General Health Questionnaire (GHQ-12) and exposure to psychosocial stress assessed on Siegrist's effort/reward and overcommitment model. METHODS: A transverse study was conducted in France on 2471 female employees in 105 nursing homes for the elderly. Personal and occupational data were collected by questionnaire for 668 housekeepers, 1454 nursing assistants and 349 nurses. RESULTS: 36.8% of participants (n=896) showed impaired mental well-being, 42.7% (n=1039) overcommitment and 9% (n=224) effort/reward imbalance. Overcommitment (prevalence ratio (PR)=1.27; 95% CI (1.21 to 1.34)) and effort-reward imbalance (PR=1.19; 95% CI (1.12 to 1.27)) were significantly associated with presence of impaired mental well-being after adjustment for personal factors (age and private life events). Taking effort and reward levels into account, the frequency of impaired mental well-being was highest in case of exposure to great extrinsic effort and low rewards of any type: esteem, PR=3.53, 95% CI (3.06 to 4.08); earnings, PR=3.48, 95% CI (2.99 to 4.06); or job security, PR=3.30, 95% CI (2.88 to 3.78). Participants in situations of overcommitment and of effort/reward imbalance were at the highest risk of impaired mental well-being: PR=3.86, 95% CI (3.42 to 4.35). CONCLUSIONS: Several changes in nursing home organisation can be suggested to reduce staff exposure to factors of psychosocial stress. Qualitative studies of the relation between impaired mental well-being and psychosocial stress in nursing home staff could guide prevention of impaired mental well-being at work.

Chaos driven by interfering memory.

The transmission of information can couple two entities of very different nature, one of them serving as a memory for the other. Here we study the situation in which information is stored in a wave field and serves as a memory that pilots the dynamics of a particle. Such a system can be implemented by a bouncing drop generating surface waves sustained by a parametric forcing. The motion of the resulting "walker" when confined in a harmonic potential well is generally disordered. Here we show that these trajectories correspond to chaotic regimes characterized by intermittent transitions between a discrete set of states. At any given time, the system is in one of these states characterized by a double quantization of size and angular momentum. A low dimensional intermittency determines their respective probabilities. They thus form an eigenstate basis of decomposition for what would be observed as a superposition of states if all measurements were intrusive.

[Predict factors associated with malnutrition from patient generated subjective global assessment (PG-SGA) in head and neck cancer patients]. / Predict factors associated with malnutrition from patient generated subjective global assessment (PG-SGA) in head and neck cancer patients.

INTRODUCTION: Patient Generated Subjective Global Assessment (PG-SGA) is a validated tool for nutrition evaluation in patients with cancer. AIM: The aim of our study was to estimate the prevalence of malnutrition in head and neck cancer patients at diagnosis and evaluate the independent prognostic factors for malnutrition from PG-SGA. MATERIAL AND METHODS: All outpatients attending at the Head and Neck Cancer Multidisciplinary Meeting for primary diagnosis, staging and treatment were evaluated by an oncology dietitian using the patient generated subjective global assessment (PG-SGA). Patients with recurrences or secondary tumours will be excluded. RESULTS: 64 patients were evaluated (55 men and 9 women) with an average age of 63 years and body mass index (BMI) of 25.3 kg/m(2) (SD ± 5.18). After the nutritional assessment we observed that 43.8% of patients were malnourished or at risk of malnutrition. The most frequent symptom at diagnosis was dysphagia (48.4%) and anorexia (26.6%). From PG-SGA, the main prognostic factors (p<0,001) were the percentage of weight loss, serum albumin levels, BMI and the presence of dysphagia or/and anorexia prior diagnosis. CONCLUSIONS: Parameters as BMI, weight loss and low albumin levels at the time of diagnosis in head and neck cancer patients are independent predictors for malnutrition as well as the presence of anorexia or dysphagia.reaffirms the need for sustainability of interventions over time.

Introducción: La valoración global subjetiva generada por el paciente (VGS-GP) es una herramienta validada para la valoración nutricional de los pacientes oncológicos. Objetivo: El objetivo de nuestro estudio es conocer la prevalencia de desnutrición de los pacientes con cáncer de cabeza y cuello en el momento del diagnóstico y evaluar los factores pronósticos independientes de desnutrición a partir de la VGS-GP. Material y métodos: Todos los pacientes ambulatorios que fueron evaluados por el Comité de Tumores de Cabeza y Cuello para diagnóstico primario, estadiaje y decisión terapéutica fueron evaluados a través de la VGSGP. Se excluyeron recidivas tumorales y segundas neoplasias. Resultados: Se evaluaron 64 pacientes (55 hombres y 9 mujeres) con una edad media de 63 2013s y un índice de masa corporal (IMC) de 25,3 kg/m2. Después de realizar la VGS-GP se observó que el 43,8% presentaban desnutrición o riesgo de padecerla. Los síntomas más frecuentes en el momento del diagnóstico fueron la disfagia (48,4%) y la anorexia (26.6%). Dentro de la VGS-GP, los principales factores pronósticos (p<0,001) fueron el porcentaje de pérdida de peso, los niveles de albúmina, el valor del IMC y la presencia de disfagia y/o anorexia. Conclusiones: Parámetros como el IMC, la pérdida de peso y las cifras de albúmina en el momento del diagnóstico de cáncer de cabeza y cuello, son factores predictivos independientes para el diagnóstico de desnutrición, así como la presencia de anorexia o disfagia.

Factores pronóstico de desnutrición a partir de la valoración global subjetiva generada por el paciente (VGS-GP) en pacientes con cáncer de cabeza y cuello / Predict factors associated with malnutrition from patient generated subjective global assessment (PG-SGA) in head and neck cancer patients

Introducción: La valoración global subjetiva generada por el paciente (VGS-GP) es una herramienta validada para la valoración nutricional de los pacientes oncológicos. Objetivo: El objetivo de nuestro estudio es conocer la prevalencia de desnutrición de los pacientes con cáncer de cabeza y cuello en el momento del diagnóstico y evaluar los factores pronósticos independientes de desnutrición a partir de la VGS-GP. Material y métodos: Todos los pacientes ambulatorios que fueron evaluados por el Comité de Tumores de Cabeza y Cuello para diagnóstico primario, estadiaje y decisión terapéutica fueron evaluados a través de la VGS-GP. Se excluyeron recidivas tumorales y segundas neoplasias. Resultados: Se evaluaron 64 pacientes (55 hombres y 9 mujeres) con una edad media de 63 años y un índice de masa corporal (IMC) de 25,3 kg/m2. Después de realizar la VGS-GP se observó que el 43,8% presentaban desnutrición o riesgo de padecerla. Los síntomas más frecuentes en el momento del diagnóstico fueron la disfagia (48,4%) y la anorexia (26.6%). Dentro de la VGS-GP, los principales factores pronósticos (p<0,001) fueron el porcentaje de pérdida de peso, los niveles de albúmina, el valor del IMC y la presencia de disfagia y/o anorexia. Conclusiones: Parámetros como el IMC, la pérdida de peso y las cifras de albúmina en el momento del diagnóstico de cáncer de cabeza y cuello, son factores predictivos independientes para el diagnóstico de desnutrición, así como la presencia de anorexia o disfagia (AU)

Introduction: Patient Generated Subjective Global Assessment (PG-SGA) is a validated tool for nutrition evaluation in patients with cancer. Aim: The aim of our study was to estimate the prevalence of malnutrition in head and neck cancer patients at diagnosis and evaluate the independent prognostic factors for malnutrition from PG-SGA. Material and methods: All outpatients attending at the Head and Neck Cancer Multidisciplinary Meeting for primary diagnosis, staging and treatment were evaluated by an oncology dietitian using the patient generated subjective global assessment (PG-SGA). Patients with recurrences or secondary tumours will be excluded. Results: 64 patients were evaluated (55 men and 9 women) with an average age of 63 years and body mass index (BMI) of 25.3 kg/m2 (SD ± 5.18). After the nutritional assessment we observed that 43.8% of patients were malnourished or at risk of malnutrition. The most frequent symptom at diagnosis was dysphagia (48.4%) and anorexia (26.6%). From PG-SGA, the main prognostic factors (p<0,001) were the percentage of weight loss, serum albumin levels, BMI and the presence of dysphagia or/and anorexia prior diagnosis. Conclusions: Parameters as BMI, weight loss and low albumin levels at the time of diagnosis in head and neck cancer patients are independent predictors for malnutrition as well as the presence of anorexia or dysphagia (AU)

Level splitting at macroscopic scale.

A walker is a classical self-propelled wave particle association moving on a fluid interface. Two walkers can interact via their waves and form orbiting bound states with quantized diameters. Here we probe the behavior of these bound states when setting the underlying bath in rotation. We show that the bound states are driven by the wave interaction between the walkers and we observe a level splitting at macroscopic scale induced by the rotation. Using the analogy between Coriolis and Lorentz forces, we show that this effect is the classical equivalent to Zeeman splitting of atomic energy levels.