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This paper presents a compact and planar reconfigurable filtenna for application in Wireless systems. The filtenna is composed of a UWB circular antenna and a filter with two trapezoidal resonators. The filter is integrated on the antenna feed line and has a band-pass frequency response. The filtenna frequency response reconfiguration is achieved by changing the capacitance of a varactor diode, placed between filter resonators; the capacitance varies continuously from 1.32 pF to 4.09 pF according to an applied bias voltage. The varactor capacitance analog variation defines the filtenna frequency of operation, which can be varied from 2.2 GHz to 3.4 GHz with an average bandwidth of 200 MHz, while maintaining the radiation characteristics of the UWB antenna. Simulated and measured filtenna results are shown according to varactor diode bias, demonstrating multiband operation using a compact planar design.

A planar sensor designed using the fourth Hilbert fractal curve iteration for solid material characterization at multiple frequencies is reported in this paper. The fractal curve is self-similar with space filling properties. The Hilbert fractal geometry is used to form a compact resonator, with a multiband frequency response where miniaturization is achieved, since a large transmission line length is effectively confined in a limited area. The sensor provides five resonances in the frequency range from 0 to 5 GHz. The resonant frequencies are 0.56, 1.68, 2.72, 3.69 and 4.72 GHz, all used to measure the real permittivity of known samples with a sensitivity of 7, 20, 27, 43 and 50 MHz/permittivity, respectively. The sensor is used to measure dielectric samples with 20 x 20 mm2 areas with several thicknesses. Simulations and measurements demonstrate that the Hilbert fractal geometry can be used to design a multiband planar sensor for solid dielectric material characterization.

To investigate the effect of omega-3 (ω-3) polyunsaturated fatty acid supplementation and a multidomain intervention (MI) (physical activity counselling, cognitive training and nutritional advice) among community-dwelling older adults on levels of intrinsic capacity (IC), a construct recently proposed by the World Health Organization.Secondary analysis from the factorial-design 3-year Multidomain Alzheimer Preventive Trial (MAPT) with 1445 subjects (64.2 % female, mean age 75.3 years, SD = 4.4) randomized to one group of MI plus ω-3 (800 mg docosahexaenoic acid and 225 mg eicosapentaenoic acid/day); MI plus placebo; ω-3 supplementation alone; or placebo alone. Data collection was held between 2008 and 2014.IC domains were examined with the Geriatric Depression Scale (psychological); Short Physical Performance Battery (mobility); Z-score combining four tests (cognitive function); and handgrip strength (vitality). All domains were combined into a composite IC Z-score.After 3 years, IC Z-score decreased among all groups when time was considered continuous (MI plus ω-3: -0.16, 95 %CI: -0.22 to -0.10; MI alone: -0.13, 95 %CI: -0.19 to -0.07; ω-3 alone: -0.19, 95 %CI: -0.25 to -0.10; placebo: -0.20, 95 %CI: -0.26 to -0.14; all p0.0001). There were no significant differences between groups. In a sensitivity analysis with categorical time, significant within-group declines were first identified at 24 months for all groups.This trial designed to improve cognitive function was unable to find effects of the intervention on the composite IC Z-score. Further investigations are needed, especially trials providing stronger interventions (such as exercise training and a controlled diet) and also embracing the sensorial domain of IC.

Understanding the drivers of greenhouse gas (GHG) emissions is one of the most critical global environmental challenges to mitigate the increasing global temperature. Nitrous oxide (N2O) emissions are highly variable in space and time and are controlled by multiple proximal drivers, that is, those that affect N2O emissions directly and in short timescales, and distal or indirect drivers that influence emissions over long timescales. Here we present a quantification of N2O emissions in grasslands and forests throughout the Pampas and the Semiarid Chaco in Argentina and reveal distal and proximal drivers, analyzing them in both spatial and temporal models. We measured N2O emissions, soil and climate variables monthly in nine sites over two years. Mean annual temperature and the following soil properties: phosphorous availability, carbon:nitrogen ratio, clay and sand percentages were the main distal drivers controlling N2O emissions in the spatial model, while among proximal drivers, only soil nitrate contents were positively related to N2O emissions. When considering the seasonal variability of N2O emissions (temporal model), we found that emissions were positively related to proximal drivers, such as soil nitrate and soil temperature. Our results show that soil N2O emission drivers differ between spatial and temporal models in natural grasslands and forests, explaining up to 85 and 56% of variations in N2O emissions, respectively. Temperature increased N2O emissions in both spatial and temporal models; therefore, future global warming may increase background emissions from natural ecosystems with important positive feedbacks on the earth system warming.

This paper presents a compact and planar reconfigurable filtenna for application in Wireless systems. The filtenna is composed of a UWB circular antenna and a filter with two trapezoidal resonators. The filter is integrated on the antenna feed line and has a band-pass frequency response. The filtenna frequency response reconfiguration is achieved by changing the capacitance of a varactor diode, placed between filter resonators; the capacitance varies continuously from 1.32 pF to 4.09 pF according to an applied bias voltage. The varactor capacitance analog variation defines the filtenna frequency of operation, which can be varied from 2.2 GHz to 3.4 GHz with an average bandwidth of 200 MHz, while maintaining the radiation characteristics of the UWB antenna. Simulated and measured filtenna results are shown according to varactor diode bias, demonstrating multiband operation using a compact planar design. © 2021 SBMO/SBMag.

Introduction: Limiting the number of dependent older people in coming years will be a major economic and human challenge. In response, the World Health Organization (WHO) has developed the «Integrated Care for Older People (ICOPE)» approach. The aim of the ICOPE program is to enable as many people as possible to age in good health. To reach this objective, the WHO proposes to follow the trajectory of an individual’s intrinsic capacity, which is the composite of all their physical and mental capacities and comprised of multiple domains including mobility, cognition, vitality / nutrition, psychological state, vision, hearing. Objective: The main objective of the INSPIRE ICOPE-CARE program is to implement, in clinical practice at a large scale, the WHO ICOPE program in the Occitania region, in France, to promote healthy aging and maintain the autonomy of seniors using digital medicine. Method: The target population is independent seniors aged 60 years and over. To follow this population, the 6 domains of intrinsic capacity are systematically monitored with pre-established tools proposed by WHO especially STEP 1 which has been adapted in digital form to make remote and large-scale monitoring possible. Two tools were developed: the ICOPE MONITOR, an application, and the BOTFRAIL, a conversational robot. Both are connected to the Gerontopole frailty database. STEP 1 is performed every 4-6 months by professionals or seniors themselves. If a deterioration in one or more domains of intrinsic capacity is identified, an alert is generated by an algorithm which allows health professionals to quickly intervene. The operational implementation of the INSPIRE ICOPE-CARE program in Occitania is done by the network of Territorial Teams of Aging and Prevention of Dependency (ETVPD) which have more than 2,200 members composed of professionals in the medical, medico-social and social sectors. Targeted actions have started to deploy the use of STEP 1 by healthcare professionals (physicians, nurses, pharmacists,…) or different institutions like French National old age insurance fund (CNAV), complementary pension funds (CEDIP), Departmental Council of Haute Garonne, etc. Perspective: The INSPIRE ICOPE-CARE program draws significantly on numeric tools, e-health and digital medicine to facilitate communication and coordination between professionals and seniors. It seeks to screen and monitor 200,000 older people in Occitania region within 3 to 5 years and promote preventive actions. The French Presidential Plan Grand Age aims to largely implement the WHO ICOPE program in France following the experience of the INSPIRE ICOPE-CARE program in Occitania.

In developing countries, agriculture generally represents a large fraction of GHG emissions reported in National Inventories, and emissions are typically estimated using Tier 1 IPCC guidelines. However, field data and locally adapted simulation models can improve the accuracy of IPCC estimations. In this study we aimed to quantify anthropogenic N

Immune checkpoint inhibitors have revolutionised cancer therapeutics. Translational research evaluating the role of biomarkers is essential to identify the ideal target population for these drugs. From a regulatory perspective, the identification of biomarkers and diagnostic assays is strongly encouraged by the European Medicines Agency (EMA). The aim of this article is to analyse the role of programmed death-ligand 1 (PD-L1) expression as a predictive biomarker in relation to the data submitted for the initial assessment of atezolizumab, a monoclonal antibody targeting human PD-L1. On 20 July 2017, atezolizumab was granted a marketing authorisation valid throughout the European Union (EU) for adult patients with (i) locally advanced or metastatic non-small-cell lung cancer (NSCLC) after chemotherapy and (ii) locally advanced or metastatic urothelial carcinoma (UC) after chemotherapy or cisplatin-ineligibility. Initially, these indications were not restricted by the level of PD-L1 expression, but preliminary data from an ongoing phase III trial in patients with UC led to a restriction in the UC indication to cisplatin-ineligible patients whose tumours have ≥5% PD-L1 expression. Still, the role of PD-L1 expression as predictive biomarker for atezolizumab therapy remains inconclusive and further research is needed. Data in this paper came from the scientific review leading to the initial regulatory approval of atezolizumab in the EU and its complementary application for indication (EMEA/H/C/004143/II/0010). The full scientific assessment report and product information are available on the EMA website (www.ema.europa.eu)., Highlights • Biomarkers are essential for identifying the proper target population for a given therapy, specifically in oncology. • PD-L1 expression has been proposed as a biomarker for patients receiving PD-1/PD-L1 inhibitors. • In patients receiving atezolizumab, the predictive value of PD-L1 expression remains controversial.

Background Sleep apnea (SA) is a burdensome and often underdiagnosed condition in heart failure (HF). Portable devices, such as ApneaLinkTM, are currently validated as a screening tool for SA. The apnea-hypopnea index (AHI) as been long considered the gold-standard measurement for the diagnosis of SA, also having a prognosis impact. Recently, however, other respiratory variables have been proposed as better prognosis predictors in patients with HF. The main goal of this study was to assess the prognostic value of other respiratory measurements evaluated by ApneaLinkTM at discharge in a population admitted for HF. Methods This was a single-center retrospective study enrolling consecutive patients admitted in a HF Clinic for acute HF from 2013 and 2018. All stable patients without previously known sleep-disordered breathing underwent ApneaLinkTM screening the night before discharge in the euvolemic state. Those with a total respiratory evaluation time Results Overall, 231 patients (mean age 74.5±10.6 years; 47% male; 83% hypertension; 41% chronic kidney disease; 44% anemia; 18% with a NYHA>2 at discharge; 43% ischaemic HF; 41% with a left ventricle ejection fraction lower than 50%) were assessed. One-hundred and sixty-nine patients (59.1%) had an AIH >15, with a median of 19 (IQR 7–42); the median number of obstructive apneas and central apneas was 13 (IQR 2–68), and 2 (IQR 0–10), respectively. Two-hundred patients (69.9%) had nocturnal periods of an oxygen saturation below 85% (T85), with a median time under that value of 8 (IQR 0–47) minutes. Over a median follow-up of 34.1 (IQR 18.40–54.37) months, 105 (45.7%) patients died and 128 (55.7%) were readmitted for AHF. After adjustment for cofounders (namely, the presence of anemia) a T85 above the 75th percentile was significantly correlated with a higher risk of HF readmission in a multivariate analysis (adjusted HR: 1.58, 95% CI: 1.08–2.30, p=0.017) (figure 1). These results were independent of the apnea-hypopnea index. Conclusion Nocturnal hypoxemia (T85) was an independent predictor of rehospitalization in patients with HF. These results further validate the utility and prognosis impact of other respiratory measurements (other than AHI) evaluated by ApneaLinkTM screening at discharge in a population of patients admitted for HF. Figure 1 Funding Acknowledgement Type of funding source: None

Background Hospitalization for Acute Heart Failure (AHF) remains an important turning point for patients and families, presenting itself as an index event after which the rate of readmission and mortality are particularly high. Hospitalization for Heart Failure (HF) also has a considerable cost impact on healthcare systems. Strategies that reduce the risk of readmission for HF are, therefore, crucial for patients and healthcare systems. A possible strategy to reduce HF readmissions currently recomended by the European Society of Cardiology is guaranteeing an outpatient follow-up visit carried out by a multidisciplinary HF team (combining specialized medical and nurse care) shortly after discharge. Our goal was to describe and demonstrate the feasibility of an early follow-up visit carried out by a multidisciplinary HF team in the transition care of HF patients, after hospital discharge, and to evaluate its association with early HF readmission and all-cause mortality. Methods This was a retrospective cohort study of acute heart failure (AHF) patients consecutively admitted to an AHF Unit during one year. Exclusion criteria were in-hospital death and transfer to another hospital. We compared patients who were evaluated in a follow-up visit carried out 7 to 14 days after hospital discharge where treatment adjustments could be made, with those who were not. Primary outcomes: AHF readmissions and all-cause mortality at 3 months after discharge were analysed. Cox proportional hazards regression was used. Results Of 181 admissions for AHF, 153 were analysed. Patients were 77±11 years-old; 54% were male and 46% had reduced left ventricular ejection fraction. At hospital discharge median NT-proBNP was 3258 (1429–5995) pg/mL. One-hundred and forty-four (94%) patients were referred to a follow-up visit by the same multidisciplinary HF team with a compliance rate of 81% (n=116). The mortality rate after 3 months was 6.5% (n=10) and the AHF readmission rate was 14.3% (n=22). An early follow-up visit was independently associated with a lower risk of AHF readmission at 3 months after discharge (crude HR 0.35, 95% Confidence Interval (CI): 0.15–0.82, p=0.015; adjusted HR for age and implantable cardiac defibrillator: 0.31, 95% CI: 0.12–0.79, p=0.014) (Figure 1A). and a lower combined risk of all-cause mortality or AHF readmission at 3 months (crude HR 0.37, 95% CI: 0.18–0.78, p=0.009; adjusted HR for age, implantable cardiac defibrillator, pacemaker presence and NYHA >2: 0.29, 95% CI: 0.13–0.67, p=0.004) (Figure 1B). Conclusion Conducting an early specialized follow-up visit after AHF hospitalization is highly feasible and associated with an excelent patient compliance. A multidisciplinary HF team visit in the vulnerable phase after AHF hospitalization was associated with a significantly lower risk of HF readmission and all-cause death at 3 months, mostly due to preventable readmissions. Funding Acknowledgement Type of funding source: None

Background In patients with heart failure (HF) and reduced left ventricle ejection fraction (LVEF), the sodium-glucose cotransporter inhibitor (iSGLT2) dapagliflozin has recently been shown to reduce the risk of worsening heart failure or death from cardiovascular causes in the DAPA-HF trial. Results of iSGLT2 in HF with preserved LVEF are awaited. Our goal was to investigate how many patients in a real-world setting would be eligible for dapagliflozin according to the DAPA-HF criteria. Methods This is a single-center retrospective study enrolling consecutive patients followed in an HF Clinic from 2013 to 2019. The key DAPA-HF inclusion criteria [i.e., Left Ventricular Ejection Fraction (LVEF) 600pg/mL (or >900pg/ml if AF)] and exclusion criteria [estimated glomerular filtration rate (eGFR) Results Overall, 479 patients (mean age 75.7±12.8 years; 50.4% male; 78.8% with hypertension; 45.0% with an eGFR 40% (67.5%), eGFR Conclusion Roughly one in every five patients in our real-world HF cohort would be eligible to start dapagliflozin according to the key criteria of the DAPA-HF trial. The main reason for non-eligibility was a LVEF >40%. These findings highlight the urgent need for disease-modifying drugs in mid-range and preserved LVEF. The results of ongoing iSGLT2 trials in these LVEF subgroups are eagerly awaited. Funding Acknowledgement Type of funding source: None

Backgrounds: The World Health Organization has published the Integrated Care for Older People, ICOPE handbook Guidance on person-centred assessment and pathways in primary care. This is an integrated individual care tool focused on the individual and healthy ageing. The ICOPE tool proposes step by step, a screening, a fine assessment, the development of a personalized care plan, its implementation and follow up and finally the consideration of the caregivers and community. The new Geroscience field is focusing on preventing age-related diseases, and should now investigate with the ICOPE tool the optimal maintenance of intrinsic capacity (IC) through mobility, cognition, psychology, vitality, hearing and vision. This article aims to present this new tool and to presents its innovative implementation at the Toulouse University Hospital through the INSPIRE study. We believe that the ICOPE integrated care program will also be a pragmatic way to maintain cognitive functions and detect early Alzheimer. Objectives: The main objective of the INSPIRE study is to build a Bio-resource Research Platform for Healthy Ageing gathering biological, clinical and digital resources in order to identify markers of ageing, age-related diseases and IC evolution. The study will be also testing the implementation and follow up of the ICOPE tool. Methods: The Inspire Platform will gather clinical data and bio-specimens from 1000 subjects in the Occitania Region, of different ages (from 30 years and over) over 10 years. Data will be collected annually. Using the ICOPE tool IC domains will be monitored every 4 months. Once IC decline is identified, participants will have a thorough clinical assessment and blood sampling to investigate the response of markers of ageing at the time of decline. The French ethic committee approved the study. Results: The Inspire platform aims to develop an integrative approach to promote novel new technologies for the assessment and monitoring of functional capacities.

The objective of this study was to perform a systematic review to investigate the effects protein, essential amino acids (EAA), β-hydroxy β-methylbutyrate (HMB), creatine, dehydroepiandrosterone (DHEA) and fatty acid supplementation on muscle mass, muscle strength and physical performance of elderly subjects. Using the electronic databases MEDLINE and EMBASE we identified RCTs published until February 2016 which assessed the effects of these nutrient supplementation on muscle strength, muscle mass or physical performance. Study selection and data extraction were performed by two independent reviewers. Search strategy allowed us to identify 23 RCTs. Among them, four used proteins as nutritional supplement, seven EAAs, six creatine, four DHEA and finally, two HMB. From our systematic review, it seems that the effects of these supplementations on muscle health are rather limited. Only consistent effects of EAA supplementation on physical performance (3 out of the 4 RCTs using EAA supplementation found significant effect of this supplementation on physical performance) and HMB supplementation on muscle mass (all the 2 identified RCTs using HMB supplementation found significant effect of this supplementation on muscle mass) have been found across studies. No consistent effects were found for the other types of dietary supplementation. Because of the important limitations in study design, inconsistency and lack of directness, the overall quality of the evidence was judged to be low or very low using the GRADE system. This systematic review showed a limited effect of nutritional supplementation on muscle mass, muscle power and physical function. Inconsistent positive effects were observed for some specific supplementations but the results only concerned one aspect of the muscle. Well designed and appropriately powered RCTs are needed to provide evidence for appropriate clinical recommendations.

RESUMEN Introducción: las mascotas generalmente son reservorios y diseminadores de hongos causantes de tiñas en humanos. Objetivo: aislar e identificar hongos dermatofitos en el pelaje de gatos asintomáticos del área metropolitana de Asunción. Materiales y métodos: se incluyeron 68 gatos asintomáticos del área metropolitana de Asunción, cuyas edades estaban entre 1 mes y 14 años. Las muestras de pelos fueron obtenidas por el método del tapete de Mariat y Tapia, se cultivaron en Agar Sabouraud con cloramfenicol y cicloheximida (agar Mycosel) y se incubaron 21 días a 28 ºC. La identificación se basó en las características macroscópicas y microscópicas de las colonias. Resultados: se aislaron hongos dermatofitos en 13 gatos: 10 (14,7%) tenían Microsporum canis y 3 (4,4%) Microsporum gypseum. No se encontró diferencias significativas en cuanto a la presencia del hongo y las variables sexo, edad, hábitat y contacto con otros animales. Conclusión: en gatos de Asunción se aislaron Microsporun canis (14,7%) y Microscporum gypseum (4,4%). ABSTRACT Introduction: pets are generally reservoirs and disseminators of fungi causing “tinea” in humans. Objective: to isolate and identify dermatophyte fungi in hair of asymptomatic cats of the metropolitan area of Asunción. Materials and methods: 68 asymptomatic cats were included from the metropolitan area of Asunción, whose ages were between 1 month and 14 years. The hair samples were obtained by the Mariat and Tapia mat method, they were cultivated in Sabouraud Agar with chloramphenicol and cycloheximide (Mycosel agar) and incubated 21 days at 28 ºC. The identification was based on the macroscopic and microscopic characteristics of the colonies. Results: dermatophyte fungi were isolated in 13 cats: 10 (14.7%) had Microsporum canis and 3 (4.4%) Microsporum gypseum. No significant differences were found regarding the presence of the fungus and the variables sex, age, habitat and contact with other animals. Conclusion: Microsporum canis (14.7%) and Microscporum gypseum (4.4%) were isolated of Asunción cats.

With aging populations around the world, frailty is becoming more prevalent increasing the need for health systems and social systems to deliver optimal evidence based care. However, in spite of the growing number of frailty publications, high-quality evidence for decision making is often lacking. Inadequate descriptions of the populations enrolled including frailty severity and frailty conceptualization, lack of use of validated frailty assessment tools, utilization of different frailty instruments between studies, and variation in reported outcomes impairs the ability to interpret, generalize and implement the research findings. The utilization of common data elements (CDEs) and core outcome measures (COMs) in clinical trials is increasingly being adopted to address such concerns. To catalyze the development and use of CDEs and COMs for future frailty studies, the Canadian Frailty Network (www.cfn-nce.ca; CFN), a not-for-profit pan-Canadian nationally-funded research network, convened an international group of experts to examine the issue and plan the path forward. The meeting was structured to allow for an examination of current frailty evidence, ability to learn from other COMs and CDEs initiatives, discussions about specific considerations for frailty COMs and CDEs and finally the identification of the necessary steps for a COMs and CDEs consensus initiative going forward. It was agreed at the onset of the meeting that a statement based on the meeting would be published and herein we report the statement.

Biomarkers of frailty and sarcopenia are essential to advance the understanding of these conditions of aging and develop new diagnostic tools and effective treatments. The International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force – a group of academic and industry scientists from around the world — met in February 2019 to discuss the current state of biomarker development for frailty and sarcopenia. The D3Cr dilution method, which assesses creatinine excretion as a biochemical measure of muscle mass, was suggested as a more accurate measure of functional muscle mass than assessment by dual energy x-ray absorptiometry (DXA). Proposed biomarkers of frailty include markers of inflammation, the hypothalamic-pituitary-adrenal (HPA) axis response to stress, altered glucose insulin dynamics, endocrine dysregulation, aging, and others, acknowledging the complex multisystem etiology that contributes to frailty. Lack of clarity regarding a regulatory pathway for biomarker development has hindered progress; however, there are currently several international efforts to develop such biomarkers as tools to improve the treatment of individuals presenting these conditions.

BACKGROUND: It is hypothesised that cotargeting the androgen receptor (AR) and paracrine androgen biosynthesis with enzalutamide and abiraterone acetate in metastatic castration-resistant prostate cancer (mCRPC) will dissipate adaptive feedback loops observed with either agent alone. OBJECTIVE: To assess the safety, efficacy, androgen signalling/metabolome, and drug-drug interactions (DDIs) of enzalutamide with abiraterone acetate in progressive bone mCRPC (bmCRPC). DESIGN, SETTING, AND PARTICIPANTS: This open-label, single-centre interventional study was conducted in bmCRPC patients. INTERVENTION: Enzalutamide 160mg and abiraterone acetate 1000mg once daily; prednisone 5mg twice daily. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Adverse events (AEs), prostate-specific antigen (PSA) response, progression-free survival (PFS), tumour biomarker/metabolite expression, and Cmin plasma concentrations were evaluated. RESULTS AND LIMITATIONS: Sixty patients were enrolled. Common AEs independent of grade/causality included fatigue (72%), hyperglycaemia (67%), alkaline phosphatase (ALP) elevation (53%), and hot flush (43%). Grade 3 AEs included hypertension (17%), alanine aminotransferase elevation (12%), ALP elevation (5%), and arthralgia (5%). No treatment-related grade 4 AEs or deaths were reported. Median treatment-discontinuation time was 312d (95% confidence interval [CI] 196.0-483.0). Maximal PSA decline ≥50% and ≥90% occurred in 46 (77%) and 29 (48%) patients, respectively. Median PFS was 251d (95% CI 147-337). At week 9, median tumour microenvironment androgens, precursors, and nuclear AR expression decreased (p

Aims: Photodegradation of senescent plant material has been identified as an important vector of aboveground carbon (C) loss in aridland ecosystems, but the consequences for biotic activity and soil C in the field are not well understood. Methods: We established an experiment in a semiarid woodland in Patagonia, Argentina with attenuation of solar radiation and additions of leaf litter to evaluate impacts of photodegradation on changes in labile C and biotic activity in aboveground litter and surface soils. Results: Litter decomposition was significantly accelerated by exposure to solar radiation. Moreover, labile sugars (hexoses and pentoses), microbial enzymatic activity (β-glucosidase activity) and available carbohydrates for cellulase degradation (saccharification) all significantly increased in sunlight-exposed litter. None of these stimulatory effects were observed in the surface soils exposed to sunlight. On the contrary, soil microbial biomass and β-glucosidase activity in surface soils were significantly greater only with litter addition and attenuated sunlight. Conclusions: Our results suggest that photodegradation of plant litter (production of volatile compounds through photochemical mineralization) and photofacilitation (stimulation of biotic activity due to change in litter chemistry with exposure to sunlight) generate rapid turnover of C in aboveground litter. The consequences of this accelerated C turnover may be that a fraction of leaf litter decomposes and is directly released back to the atmosphere as CO2 and never enters soil organic matter pool. Taken together, these results highlight the functional importance of solar radiation in determining the C balance in semiarid ecosystems. Fil: Méndez Zacarías, Jovita Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura. Universidad de Buenos Aires. Facultad de Agronomía. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura; Argentina Fil: Martínez, María Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura. Universidad de Buenos Aires. Facultad de Agronomía. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura; Argentina Fil: Araujo, Patricia Inés. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura. Universidad de Buenos Aires. Facultad de Agronomía. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura; Argentina. Instituto Nacional de Tecnología Agropecuaria; Argentina Fil: Austin, Amy Theresa. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura. Universidad de Buenos Aires. Facultad de Agronomía. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura; Argentina

In this paper, a new frequency selective surface (FSS) for antenna gain enhancement is proposed. The antenna and FSS have an isosceles trapezium geometry. Three different versions of an antenna are created. For each version, the S-parameters S11 and S21 were simulated with the software CST Microwave Studio®. Then, one of the three trapezoid antennas is simulated with an FSS. These two devices, antenna and FSS, were manufactured and had the S11 and S21 parameters measured at the laboratory. The resonance frequency obtained for the trapezium FSS was equal to 2.27 GHz for $\alpha$ equal to 0 °, 2.70 GHz for $\alpha$ equal to 15 ° and 3.12 GHz for $\alpha$ equal to 30 °. The simulated antenna gain increased when the FSS is used as superstrate. Without the presence of the FSS, a maximum gain of approximately 1.50 db occurs at 2.20 GHz, when using the FSS as superstrate, the gain increases to approximately 5.25 db. The measured results agree with the simulated results.

Background Sleep Apnea (SA) is increasingly recognized in patients (pts) with Heart Failure (HF). Nocturnal polysomnography (PSG) is the gold-standard to diagnose SA. Currently, portable devices have been thoroughly validated in HF cohorts. Purpose To determine the correlation between clinical, laboratory and respiratory measurements with the presence of SA (defined as apnea-hypopnea index (AHI) >15/h) and desaturation time with SpO2 Methods Our work is based on a single-center retrospective cohort of pts hospitalized for decompensated HF during 2013–2018. All pts were screened for SA with ApneaLinkTM after compensation the night preceding discharge. HF was defined as recommended by the European Society of Cardiology guidelines. A left ventricular ejection fraction ≤45% and >45% was used to define HFrEF and HFpEF, respectively, as per SERVE-HF trial. Results A total of 228 pts were included in the analysis (mean age 75.3±10.5 years, 48.9% male). SA was present in 135 (59.2%) pts and 41.2% had HFrEF. Mean AHI was 24.5±19.2/h, mean O2 desaturation index (ODI) was 24.4±21.0/h and mean T90 was 169.6±151.2 minutes. In multivariate models, ODI, gender and ischemic HF were predictors of AHI >15/h (R2 65.8%), with ODI being the strongest predictor (standardized coefficient 64.8%). Similarly, mean SpO2 was the only predictor of T90 ≥22minutes (R2 65.8%) (Figure 1). HFrEF pts had more often AHI>15/h (73.4% vs 48.5%, p15/h and T90 ≥22 minutes in both groups, respectively. Conclusions SA was highly prevalent in HFrEF and HFpEF. ODI and mean SpO2 were highly predictive of AHI >15/h and T90 ≥22minutes, respectively, both prognostic markers validated in a population with HFrEF, and equally so in HFrEF and HFpEF. These findings hypothesize a similar pathophysiology of SA in HF, regardless of left ventricular systolic function. Also, whether simple pulse oximetry can be routinely used for SA screening, since PSG and portable devices are often not widely available, is a finding worth being prospectively assessed. Acknowledgement/Funding None

Introduction Heart Failure (HF) is a burdensome syndrome with significant mortality, morbidity and costs. Its prognosis is further aggravated by diabetes mellitus (DM). The EMPA-REG OUTCOME trial suggested that empagliflozin significantly reduced HF hospitalizations compared to placebo in patients with DM. Purpose We aimed to investigate which patients with chronic HF and DM in the outpatient setting could have been enrolled in the main empagliflozin trial. Methods This analysis is based on a retrospective cohort enrolling chronic HF patients who consecutively attended the HF appointment between January and July 2018. Of these, those with concomitant DM were selected and further analysed. The key EMPA-REG OUTCOME trial inclusion criteria [(i.e., hemoglobin A1c 7–10%, high cardiovascular (CV) risk and glomerular filtration rate [GFR] ≥30mL/min/1,73m2) were considered. Further, the European Medicine Agency (EMA) restriction (GFR>60mL/min/1,73m2) was also considered in an additional analysis. Results Of 316 patients with HF, 114 (36%) concomitantly had DM. Mean age was 74±10 years, 63% were male and most (54%) had preserved left ventricular ejection fraction. Ischemic (51%) and hypertensive (27%) HF were the most often observed etiologies. According to the inclusion criteria, 21 (18.4%) (or 5.3% when further considering the EMA restriction) HF patients could have been potentially enrolled in the main trial and derive a HF hospitalization reduction benefit from starting empagliflozin. The remainder would be excluded due to GFR10%) could be switched to a SGLT2 inhibitors, hence possibly expanding the indication to start empagliflozin to 36.8% of our HF cohort. Figure 1 Conclusions Roughly 1 in every 5 patients with HF and DM could have been enrolled in the main empagliflozin trial, as per key inclusion criteria, and potentially derive CV benefit from it. Thus, only a minority of our cohort shared the features for EMPA-REG OUTCOME trial inclusion, limiting the extrapolation of the trial's observed CV benefits to our HF cohort. Indeed, whether these benefits also expand to overall HF cohort is eagerly awaited by ongoing trials. Acknowledgement/Funding None

Background Myeloid derived suppresor cells (MDSC) are a heterogeneous population of immature myeloid cells that inhibits antitumor responses by T lymphocytes. High levels of MDSC have been found in the tumor microenvironment, which is correlated with a poor prognosis of the disease. Our purposes are to evaluate the objective response rate (ORR) to test the treatment efficacy and to show the decrease of MDSC in clinical benefit (CB) patients, that includes complete response (CR), partial response (PR) and stabilization of disease (SD), when compared with progression of disease (PD). Methods 58 patients diagnosed of R/R DLBCL who were not high dose chemotherapy and autologous bone narrow transplantation candidates were recruited from Spanish hospitals. The patients progressed to a prior R-CHOP therapy and had ECOG ≤ 1. They were treated with the R2-GDP chemotherapy schedule (rituximab, lenalidomide, gemcitabine, dexamethasone and cisplatin). Three peripheral blood analysis were carried out: basal, cycle 3 (C3) and end of induction (EI) by flow cytometry to determine the MDSC level. Results 30 patients obtained CB response to treatment (PR 11 patients, CR 14 patients and SD 5 patients) and 28 patients obtained PD. A remarkable decrease of MDSC is shown in the Table, except in PD patients. On the other hand, ORR was 69% at C3 (PR 53%+ CR 16%) and 66% at EI (PR 40% + CR 26%). Table . 1267P MDSC levels (cells/uL) in CB (CR, PR, SD) and PD. Av: average; St: Standard Deviation; *: Statistically significant differences (P Response Basal Av (St) C3 Av (St) EI Av (St) CB 19.9 (4.0) 10.0 (3.1) 4.8 (2.1)* CR 18.6 (4.9) 12.4 (3.7) 2.7 (1.1)* PR 13.0 (3.2) 4.5 (0.8) 1.4 (0.5)* SD 35.3 (14.8) 18.8 (11.6) 18.5 (9.2) PD 10.7 (4.0) 8.6 (2.4) 12.2 (2.9) Conclusions The ORR obtained shown the treatment efficacy in R/R DLBCL to stimulate the immune system antitumor response, which explains the decrease of MDSC in all CB groups and a non-important increase in PD patients. Based on these results, MDSC seem to be an important therapeutic target against tumor progression, as well as being a potentially promising marker of response. Clinical trial identification EudraCT number: 2014-001620-29. Legal entity responsible for the study Grupo Espanol para el Tratamiento y Estudio de los Linfomas (GOTEL). Funding Grupo Espanol para el Tratamiento y Estudio de los Linfomas (GOTEL). Disclosure All authors have declared no conflicts of interest.

RESUMEN El objetivo de este estudio fue identificar las especies de Candida spp. aisladas de secreción vaginal de pacientes embarazadas y no embarazadas y relacionarlas con la microscopía, síntomas y signos característicos de la vaginitis causada por esta levadura. Se estudiaron 743 muestras de secreción vaginal de pacientes que acudieron al Departamento de Bacteriología y Micología del Laboratorio Central en el 2015. Las muestras fueron sembradas en CHROM agar Candida y agar Sabouraud. La identificación se hizo por macro y micromorfología, pruebas bioquímicas, auxonograma y método comercial. En las 522 pacientes embarazadas se aislaron 536 Candida spp.: C. albicans 463 (86,4%), C. glabrata 46 (8,6%), C. krusei 9 (1,7%), C. parapsilosis 9 (1,7%), C. tropicalis 8 (1,5%), C. lusitaniae 1 (0,1%).En las 221 pacientes no embarazadasse aislaron 222 Candida spp.: C. albicans 163 (73,4%), C. glabrata 31 (14%), C. krusei 10 (4,6%), C. parapsilosis 9 (4,1%), C. tropicalis 6 (2,7%), C. guilliermondii 1 (0,4%), C. kefyr 1 (0,4%) y C. novergensis 1 (0,4%). Se observó un mayor porcentaje de aislamiento de Candida no albicansen las no embarazadas (26,6% vs 13,6%). En 15 pacientes (2%) se aislaron dos especies de Candida.Tanto en embarazadas como no embarazadas el prurito, la reacción inflamatoria y la presencia de pseudohifas fueron más frecuentes cuando el aislamiento era C. albicans. Enfatizamos la importancia de la siembra de las muestras en agar cromogénico para identificar y diferenciar especies de Candida para la epidemiología y un tratamiento eficazde la vaginitis causada por esta levadura. ABSTRACT The objective of this study was to identify Candida spp. isolated from vaginal secretion of pregnant and non-pregnant women and relate them with microscopy, symptoms and signs characteristic of vaginitis caused by this yeast. A total of 743 vaginal secretion samples wasstudied from patients consulting at the Department of Bacteriology and Mycology of the Central Laboratory in 2015. All samples were cultured on CHROM agar Candida and Sabouraud agar. The identification was made by macro and micromorphology, biochemical tests, auxonogram and commercial method. In pregnant patients (n = 522), 536 Candida spp. were isolated: C. albicans 463 (86.4%), C. glabrata 46 (8.6%), C. krusei 9 (1,7%), C. parapsilosis 9 (1.7%), C. tropicalis 8 (1.5%), C. lusitaniae 1 (0.1%). In no-pregnant patients (n = 221),222 Candida spp.were isolated: C. albicans 163 (73.4%), C. glabrata 31 (14%), C. krusei 10 (4.6%), C. parapsilosis 9 (4.1%), C. tropicalis 6 (2.7%), C. guilliermondii 1 (0.4%), C. kefyr 1 (0.4%) and C. novergensis 1 (0.4%).In the non-pregnant women, a higher percentage of non-albicans Candida species isolation was observed (26.6% vs 13.6%). Fifteen patients (2%) with two Candida species were detected. In pregnant as well non pregnant women, presence of pruritus, inflammatory reactions and and presence of pseudohifas were more frequent when Candida albicans was isolated.We emphasize the importance of culturing samples in chromogenic agar to identify and differentiate Candida species for epidemiology and an effective treatment of the vaginitis caused by this yeast.

Carbon dioxide emissions to the atmosphere from human activity continue to increase, and accordingly, strategies of biological carbon (C) sequestration in terrestrial ecosystems have been proposed. Forestation projects have garnered wide public support, and research has focused principally on how soil C storage is affected. Nevertheless, our mechanistic understanding of how forestation, particularly with exotic woody species, affects ecosystem processes is not well understood. We took advantage of a land-use change in Patagonia, Argentina, that involved the simultaneous planting of a single conifer species (Pinus ponderosa) along a broad precipitation gradient [250–2200 mm mean annual precipitation (MAP)], replacing natural ecosystems from semi-arid steppe to broadleaf forest. Comparing C fluxes and stocks in five paired natural and planted forest sites during three consecutive years demonstrated that aboveground net primary production (ANPP) was consistently greater in forested areas along the gradient, while litter decomposition markedly decreased. Dramatic increases in leaf litter detritus, coupled with increased aboveground woody biomass, contributed to identical levels of C accumulation in pine plantations from 250 mm to 1350 mm MAP, without significantly detectable differences in surface soil C. The replacement of intact forest in the most humid site resulted in large decreases in vegetation C pools. The implications for ecosystem C cycling suggest that inhibition of C turnover, along with the aboveground woody growth, are key variables contributing to the observed patterns of C accumulation from exotic pine forestation along this precipitation gradient. Given the transient nature of these C stocks, vulnerable to loss as CO2 due to climatic or anthropogenic disturbances, these changes may not contribute to long-term C sequestration in these ecosystems. The conversion of natural ecosystems as a management tool for C mitigation should include a consideration of the realized sequestration potential but also the unintended consequences for changes in both C inputs and C turnover that determine the ecosystem C balance, as well as potential effects on biodiversity and long-term ecosystem functioning.

Objectives Serous cystic neoplasm (SCN) is a cystic neoplasm of the pancreas whose natural history is poorly known. The purpose of the study was to attempt to describe the natural history of SCN, including the specific mortality. Design Retrospective multinational study including SCN diagnosed between 1990 and 2014. Results 2622 patients were included. Seventy-four per cent were women, and median age at diagnosis was 58 years (16–99). Patients presented with non-specific abdominal pain (27%), pancreaticobiliary symptoms (9%), diabetes mellitus (5%), other symptoms (4%) and/or were asymptomatic (61%). Fifty-two per cent of patients were operated on during the first year after diagnosis (median size: 40 mm (2–200)), 9% had resection beyond 1 year of follow-up (3 years (1–20), size at diagnosis: 25 mm (4–140)) and 39% had no surgery (3.6 years (1–23), 25.5 mm (1–200)). Surgical indications were (not exclusive) uncertain diagnosis (60%), symptoms (23%), size increase (12%), large size (6%) and adjacent organ compression (5%). In patients followed beyond 1 year (n=1271), size increased in 37% (growth rate: 4 mm/year), was stable in 57% and decreased in 6%. Three serous cystadenocarcinomas were recorded. Postoperative mortality was 0.6% (n=10), and SCN9s related mortality was 0.1% (n=1). Conclusions After a 3-year follow-up, clinical relevant symptoms occurred in a very small proportion of patients and size slowly increased in less than half. Surgical treatment should be proposed only for diagnosis remaining uncertain after complete workup, significant and related symptoms or exceptionally when exists concern with malignancy. This study supports an initial conservative management in the majority of patients with SCN. Trial registration number IRB 00006477.

We used 138,976 records of information of body weights ranging from 60 to 610 days of age, from 27,327 Nelore cattle of herds in the state of Mato Grosso. The random regression model with the covariance function of fourth order to describe the variability of the effects of additive genetic, animal and maternal permanent environment and maternal genetic effect and maternal, showed heritability estimates from 0.209 to 0.423 at the beginning by the end of the trajectory, respectively. There is enough genetic variability to promote genetic gain satisfactory performance for weight after weaning period the animals. Keywords: beef cattle, genetic parameters, selection.

Surface litter decomposition in arid and semiarid ecosystems is often faster than predicted by climatic parameters such as annual precipitation or evapotranspiration, or based on standard indices of litter quality such as lignin or nitrogen concentrations. Abiotic photodegradation has been demonstrated to be an important factor controlling aboveground litter decomposition in aridland ecosystems, but soil fauna, particularly macrofauna such as termites and ants, have also been identified as key players affecting litter mass loss in warm deserts. Our objective was to quantify the importance of soil organisms on surface litter decomposition in the Patagonian steppe in the absence of photodegradative effects, to establish the relative importance of soil organisms on rates of mass loss and nitrogen release. We estimated the relative contribution of soil fauna and microbes to litter decomposition of a dominant grass using litterboxes with variable mesh sizes that excluded groups of soil fauna based on size class (10, 2, and 0.01 mm), which were placed beneath shrub canopies. We also employed chemical repellents (naphthalene and fungicide). The exclusion of macro- and mesofauna had no effect on litter mass loss over 3 years (P = 0.36), as litter decomposition was similar in all soil fauna exclusions and naphthalene-treated litter. In contrast, reduction of fungal activity significantly inhibited litter decomposition (P < 0.001). Although soil fauna have been mentioned as a key control of litter decomposition in warm deserts, biogeographic legacies and temperature limitation may constrain the importance of these organisms in temperate aridlands, particularly in the southern hemisphere.

Background Targeting HER-2/neu with Trastuzumab has been associated with development of cardiac toxicity.

Background: stool type represents an important semiologic part of medical interviews. The Bristol Scale Stool Form is a clinical tool to evaluate stool consistency and form. The aim of this study was to translate and adapt the Bristol Scale Stool Form into Spanish. Differences in validation results between health professionals and patients surveyed were also evaluated. Methods: the study population included 79 physicians, 79 nurses, and 78 patients. Subjects were invited to match a randomly selected text defining one of the seven stool types in the scale with one of seven drawings described originally. A random selection of samples was offered for re-test reliability. Results: the overall Kappa index was 0.708. Thirty-two subjects repeated the test for a test-retest assessment in a mean interval of 7.76 days, and the percentage concordance between definition and image was 84.4% with a Kappa index of 0.816. There were no differences in the validation study between physicians, nurses, and patients. Conclusions: this study has shown that the Spanish version of the Bristol Scale Stool Form is reliable for use as a tool to evaluate stool consistency and form.