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Background: The percentage of older patients undergoing surgery for early-stage breast cancer has decreased over the past decade. This study aimed to develop a prediction model for postoperative complications to better inform patients about the benefits and risks of surgery, and to investigate the association between complications and functional status and quality of life (QoL). Methods: Women aged at least 70 years who underwent surgery for Tis--3 N0 breast cancer were included between 2013 and 2018. The primary outcome was any postoperative complication within 30 days after surgery. Secondary outcomes included functional status and QoL during the first year after surgery, as assessed by the Groningen Activity Restriction Scale and the European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-BR23 questionnaires. A prediction model was developed using multivariable logistic regression and validated externally using data from the British Bridging the Age Gap Study. Linear mixed models were used to assess QoL and functional status over time. Results: The development and validation cohorts included 547 and 2727 women respectively. The prediction model consisted of five predictors (age, polypharmacy, BMI, and type of breast and axillary surgery) and performed well in internal (area under curve (AUC) 0.76, 95 per cent c.i. 0.72 to 0.80) and external (AUC 0.70, 0.68 to 0.72) validations. Functional status and QoL were not affected by postoperative complication after adjustment for confounders. Conclusion: This validated prediction model can be used to counsel older patients with breast cancer about the postoperative phase. Postoperative complications did not affect functional status nor QoL within the first year after surgery even after adjustment for predefined confounders. [ABSTRACT FROM AUTHOR]

The aim of this paper is to review intranasal trigeminal system and associated reflexes. The literature survey was performed on PubMed, ProQuest Central database of Kirikkale University and Google Scholar. The intranasal trigeminal system and associated reflexes play an important role in humans in both health and disease, including in rhinitis of non-allergic and mixed type. The intranasal trigeminal nerve provides sensory perception to the lining of the nose, supplying information on how patent the nasal airway is and responding to various chemical signals. The reflexes known to exist within the intranasal trigeminal system are nasobronchial reflex, trigemino-cardiac reflex, nasogastric reflex, and nasal cycle. The intranasal trigeminal system and its reflexes play a vital role in normal human physiology. Alterations in how this system operates may underlie multiple forms of rhinitis and more research is needed to fully understand the mechanisms involved. [ABSTRACT FROM AUTHOR]

Abstract: Although nasal hyperreactivity (NHR) is a common feature in patients suffering from allergic and nonallergic rhinitis, it is widely neglected during history taking, underdiagnosed in the majority of patients with rhinitis and rhinosinusitis, not considered as an outcome parameter in clinical trials on novel treatments for rhinitis and rhinosinusitis, and no target for routine treatment. In contrast to the simple nature of diagnosing NHR by a history of nasal symptoms induced by nonspecific exogenous and/or endogenous triggers, quantification is hardly performed in routine clinic given the lack of a simple tool for its diagnosis. So far, limited efforts have been invested into gaining better insight in the underlying pathophysiology of NHR, helping us to explain why some patients with inflammation develop NHR and others not. Of note, environmental and microbial factors have been reported to influence NHR, contributing to the complex nature of understanding the development of NHR. As a consequence of the neglect of NHR as a key clinical feature of rhinitis and chronic rhinosinusitis (CRS), patients with NHR might be suboptimally controlled and/or dissatisfied with current treatment. We here aim to provide a comprehensive overview of current knowledge on the pathophysiology, and the available tools to diagnose and treat NHR. [ABSTRACT FROM AUTHOR]

Abstract: Background: Nasal hyperreactivity (NHR) is an important clinical feature of allergic rhinitis (AR). The efficacy of MP29‐02 (azelastine hydrochloride (AZE) and fluticasone propionate [FP]) nasal spray on local inflammatory mediators and NHR in AR is unknown. We tested if MP29‐02 decreases inflammatory mediators and NHR in AR and if this effect is due to restoration of nasal epithelial barrier function. Methods: A 4‐week double‐blinded placebo‐controlled trial with MP29‐02 treatment was conducted in 28 patients with house dust mite (HDM) AR. The presence of NHR was evaluated by measuring reduction in nasal flow upon cold dry air exposure. The effects of AZE ± FP on barrier integrity and airway inflammation were studied in a murine model of HDM‐induced NHR and on reduced activation of murine sensory neurons and human mast cells. Results: MP29‐02 but not placebo reduced NHR (P < .0001 vs P = .21), levels of substance P (P = .026 vs P = .941), and β‐hexosaminidase (P = .036 vs P = .632) in human nasal secretions. In wild‐type C57BL6 mice, the reduction in β‐hexosaminidase levels (P < .0001) by AZE + FP treatment upon HDM challenge was found in parallel with a decreased transmucosal passage (P = .0012) and completely reversed eosinophilic inflammation (P = .0013). In vitro, repeated applications of AZE + FP desensitized sensory neurons expressing the transient receptor potential channels TRPA1 and TRPV1. AZE + FP reduced MC degranulation to the same extent as AZE alone. Conclusion: MP29‐02 treatment reduces inflammatory mediators and NHR in AR. The effects of AZE + FP on MC degranulation, nasal epithelial barrier integrity, and TRP channels provide novel insights into the pathophysiology of allergic rhinitis. [ABSTRACT FROM AUTHOR]

This study presents FABM-PCLake, a complete redesign of the PCLake aquatic ecosystem model, which we implemented into the Framework for Aquatic Biogeochemical Models (FABM). In contrast to the original model, which was designed for temperate, fully mixed freshwater lakes, the new FABM-PCLake represents an integrated aquatic ecosystem model that enables simulations of hydrodynamics and biogeochemical processes for zero7 dimensional, one-dimensional as well as three-dimensional heterogeneous environments. FABM-PCLake describes interactions between multiple trophic levels, including piscivorous, zooplanktivorous and benthivorous fish, zooplankton, zoobenthos, three groups of phytoplankton and rooted macrophytes. The model also accounts for oxygen dynamics and nutrient cycling for nitrogen, phosphorus and silicon, both within the pelagic and benthic domains. FABM-PCLake includes a two-way communication between the biogeochemical processes and the physics, where some biogeochemical state variables (e.g., phytoplankton) influence light attenuation and thereby the spatial and temporal distributions of light and heat. At the same time, the physical environment, including water currents, light and temperature influence a wide range of biogeochemical processes. The model enables studies on ecosystem dynamics in physically heterogeneous environments (e.g., stratifying water bodies, and water bodies with horizontal gradient in physical and biogeochemical properties), and through FABM also enables data assimilation and multi-model ensemble simulations. Examples of relevant model applications include climate change impact studies and environmental impact assessment scenarios for lakes and reservoirs worldwide. [ABSTRACT FROM AUTHOR]

The hydraulic design of a tilting weir is presented, which allows for periodic exchange of potadromous fish between freshwater ecosystems. The application domain includes inland waters that need to be isolated hydraulically, preserving the existing ecological connection with the surrounding areas as much as possible. In the absence of a hydraulic gradient, the weir is opened in its neutral position and fish can bypass through passages sideways of the weir. When a hydraulic gradient develops in either of two directions, the weir rotates until a new balance of moments of force is reached, while fish can still bypass. Above a threshold value of the hydraulic gradient, the weir falls shut. When the hydraulic gradient returns to zero, the weir reopens, restoring the ecological connection. Four variants of the weir were investigated in the Hydraulics Laboratory at Wageningen University. The versatility of the design is demonstrated by showing that the hydraulic gradients required for closure and reopening can be manipulated largely independently. Patterns of flow velocity and turbulence kinetic energy were analyzed, which suggest that relevant fish species can bypass the weir unimpeded. The effectiveness of the weir will mainly depend on hydrostatic aspects, which determine when the weir is opened and closed, and on the absence of large hydraulic gradients in the migration season. [ABSTRACT FROM AUTHOR]

Abstract: This contribution addresses the problem of the generalized synchronization (GS) in different chaotic systems, and departs from chaotic systems in a triangular from, which can be derived from Lie derivatives. A state-feedback (full knowledge of both master and slave systems) scheme is designed, which achieves GS. The work includes illustrative examples; moreover an experimental setup is used to corroborate the obtained results. [Copyright &y& Elsevier]