Cluster Analysis To Identify Elderly People's Profiles: A Healthcare Strategy Based On Frailty Characteristics.

The new social panorama resulting from aging of the Brazilian population is leading to significant transformations within healthcare. Through the cluster analysis strategy, it was sought to describe the specific care demands of the elderly population, using frailty components. Cross-sectional study based on reviewing medical records, conducted in the geriatric outpatient clinic, Hospital de Clínicas, Universidade Estadual de Campinas (Unicamp). Ninety-eight elderly users of this clinic were evaluated using cluster analysis and instruments for assessing their overall geriatric status and frailty characteristics. The variables that most strongly influenced the formation of clusters were age, functional capacities, cognitive capacity, presence of comorbidities and number of medications used. Three main groups of elderly people could be identified: one with good cognitive and functional performance but with high prevalence of comorbidities (mean age 77.9 years, cognitive impairment in 28.6% and mean of 7.4 comorbidities); a second with more advanced age, greater cognitive impairment and greater dependence (mean age 88.5 years old, cognitive impairment in 84.6% and mean of 7.1 comorbidities); and a third younger group with poor cognitive performance and greater number of comorbidities but functionally independent (mean age 78.5 years old, cognitive impairment in 89.6% and mean of 7.4 comorbidities). These data characterize the profile of this population and can be used as the basis for developing efficient strategies aimed at diminishing functional dependence, poor self-rated health and impaired quality of life.132224-3

The combined effect of anemia and dynapenia on mortality risk in older adults: 10-Year evidence from the ELSA cohort study

BACKGROUND/OBJECTIVE: Anemia and dynapenia can occur simultaneously. Separately, both conditions increase the mortality risk with advancing age. However, there is no epidemiological evidence on the combined effect of these conditions on mortality in older adults. We investigated whether combined anemia and dynapenia increase the mortality risk, and whether there are gender differences. METHODS: A 10-year follow-up study was conducted involving 5,310 older adults from the English Longitudinal Study of Ageing (ELSA). According to the diagnosis of anemia (hemoglobin concentration < 13.0 g/dL in men and < 12.0 g/dL in women) and dynapenia (grip strength < 26 kg for men and < 16 kg for women), individuals at baseline were categorized as "non-anemic/non-dynapenic", "dynapenic", "anemic" and "anemic/dynapenic". The outcome was all-cause mortality during the follow-up period. RESULTS: A total of 984 deaths were computed during the follow-up (63.7% in non-anemic/non-dynapenic, 22.8% in dynapenic, 7.5% in anemic and 6.0% in anemic/dynapenic). Adjusted Cox proportional hazard models stratified by sex showed that anemia and dynapenia combined was associated with an increased mortality risk in men (HR: 1.64; 95% IC 1.08 - 2.50) and women (HR: 2.17; 95% CI 1.44 - 3.26). Anemia in men (HR: 1.68; 95% CI 1.22 - 2.32) and dynapenia in women (HR: 1.37; 95% CI 1.09 - 1.72) were also risk factors for mortality. CONCLUSIONS: The coexistence of anemia and dynapenia increases the mortality risk, highlighting the need for early identification, prevention, and treatment of these conditions to reduce their complications and the mortality risk

PREVALÊNCIA DE SARCOPENIA E FATORES ASSOCIADOS EM IDOSOS INSTITUCIONALIZADOS: UMA REVISÃO SISTEMÀTICA

Objetivo: O objetivo deste estudo foi realizar uma revisão sistemática sobre a prevalência de sarcopenia e fatores associados em idosos institucionalizados. Estratégia de Pesquisa: Esta revisão foi delineada de acordo com as recomendações propostas pelo checklist MOOSE, após registro do protocolo com o PROSPERO (CRD42018109485). Consultaram-se as bases de dados Medline, SciELO, LILACS, SCOPUS, Web of Science, ScienceDirect, Oxford Journals e Directory of Open Access Journals, usando os descritores “Sarcopenia”, “Homes for the Aged” e “Aged” (MeSH), sem limitação de tempo, linguagem ou tipo de acesso. Critérios de Seleção: Obrigatoriamente, foram selecionados estudos transversais, realizados com idosos institucionalizados, que verificaram a prevalência de sarcopenia neste contexto (sarcopenia como variável dependente). Estudos fora destes critérios foram excluídos. Resultados: Foram encontrados 288 artigos, dos quais treze foram incluídos. A prevalência de sarcopenia foi de 46,15±18,5% (20,9-85,4%) e os principais fatores associados foram o baixo índice de massa corporal, a desnutrição, o aumento da idade e o sexo (masculino e feminino), respectivamente. A Escala Newcastle-Ottawa identificou nove estudos com alta qualidade equatro estudos com moderada qualidade metodológica. Conclusão: Esta revisão demonstra que a prevalência de sarcopenia em idosos nstitucionalizados é alta, com grande variabilidade e está associada, principalmente, ao déficit nutricional, ao aumento da idade e ao sexo. Ainda, há uma necessidade de padronizar consensos e avaliações para esta população, bem como instruir dirigentes, profissionais de saúde e familiares destes idosos sobre a sarcopenia e suas complicações

Terrestrial Very-Long-Baseline Atom Interferometry:Workshop Summary

This document presents a summary of the 2023 Terrestrial Very-Long-Baseline Atom Interferometry Workshop hosted by CERN. The workshop brought together experts from around the world to discuss the exciting developments in large-scale atom interferometer (AI) prototypes and their potential for detecting ultralight dark matter and gravitational waves. The primary objective of the workshop was to lay the groundwork for an international TVLBAI proto-collaboration. This collaboration aims to unite researchers from different institutions to strategize and secure funding for terrestrial large-scale AI projects. The ultimate goal is to create a roadmap detailing the design and technology choices for one or more km-scale detectors, which will be operational in the mid-2030s. The key sections of this report present the physics case and technical challenges, together with a comprehensive overview of the discussions at the workshop together with the main conclusions

Cold atoms in space: community workshop summary and proposed road-map

We summarise the discussions at a virtual Community Workshop on Cold Atoms in Space concerning the status of cold atom technologies, the prospective scientific and societal opportunities offered by their deployment in space, and the developments needed before cold atoms could be operated in space. The cold atom technologies discussed include atomic clocks, quantum gravimeters and accelerometers, and atom interferometers. Prospective applications include metrology, geodesy and measurement of terrestrial mass change due to, e.g., climate change, and fundamental science experiments such as tests of the equivalence principle, searches for dark matter, measurements of gravitational waves and tests of quantum mechanics. We review the current status of cold atom technologies and outline the requirements for their space qualification, including the development paths and the corresponding technical milestones, and identifying possible pathfinder missions to pave the way for missions to exploit the full potential of cold atoms in space. Finally, we present a first draft of a possible road-map for achieving these goals, that we propose for discussion by the interested cold atom, Earth Observation, fundamental physics and other prospective scientific user communities, together with the European Space Agency (ESA) and national space and research funding agencies.publishedVersio

Cold atoms in space: community workshop summary and proposed road-map

We summarise the discussions at a virtual Community Workshop on Cold Atoms in Space concerning the status of cold atom technologies, the prospective scientific and societal opportunities offered by their deployment in space, and the developments needed before cold atoms could be operated in space. The cold atom technologies discussed include atomic clocks, quantum gravimeters and accelerometers, and atom interferometers. Prospective applications include metrology, geodesy and measurement of terrestrial mass change due to, e.g., climate change, and fundamental science experiments such as tests of the equivalence principle, searches for dark matter, measurements of gravitational waves and tests of quantum mechanics. We review the current status of cold atom technologies and outline the requirements for their space qualification, including the development paths and the corresponding technical milestones, and identifying possible pathfinder missions to pave the way for missions to exploit the full potential of cold atoms in space. Finally, we present a first draft of a possible road-map for achieving these goals, that we propose for discussion by the interested cold atom, Earth Observation, fundamental physics and other prospective scientific user communities, together with the European Space Agency (ESA) and national space and research funding agencies

Cold atoms in space: community workshop summary and proposed road-map

We summarise the discussions at a virtual Community Workshop on Cold Atoms in Space concerning the status of cold atom technologies, the prospective scientific and societal opportunities offered by their deployment in space, and the developments needed before cold atoms could be operated in space. The cold atom technologies discussed include atomic clocks, quantum gravimeters and accelerometers, and atom interferometers. Prospective applications include metrology, geodesy and measurement of terrestrial mass change due to, e.g., climate change, and fundamental science experiments such as tests of the equivalence principle, searches for dark matter, measurements of gravitational waves and tests of quantum mechanics. We review the current status of cold atom technologies and outline the requirements for their space qualification, including the development paths and the corresponding technical milestones, and identifying possible pathfinder missions to pave the way for missions to exploit the full potential of cold atoms in space. Finally, we present a first draft of a possible road-map for achieving these goals, that we propose for discussion by the interested cold atom, Earth Observation, fundamental physics and other prospective scientific user communities, together with the European Space Agency (ESA) and national space and research funding agencies

Study of gene expression profile in acute leukemias by microarray assay

Orientador: Fernando Ferreira CostaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias MedicasResumo: No presente estudo analisou-se a expressão gênica por microarray em 17 casos de Leucemia Mielóide Aguda (LMA), 5 casos de Leucemia Linfóide Aguda (LLA), tendo como controle 4 amostras de células progenitoras de sangue periférico coletadas de doadores de transplante de medula óssea após estimulação com G-CSF. Para isto foram utilizadas membranas de microarray contendo cerca de 4700 fragmentos de cDNA correspondendo a genes conhecidos ou a ESTs, construídas no Instituto Ludwig de Pesquisa do Câncer/FAPESP a partir dos clones de cDNA gerados pelo Projeto Genoma Humano do Câncer. Suas principais vantagens são (1) a utilização da metodologia ORESTES na construção da biblioteca de ESTs, o que a torna mais representativa da parte central dos genes; (2) ser desenvolvida com clones cDNA provenientes do Projeto Genoma Humano do Câncer e, portanto, com potencial de conter genes não disponíveis nas membranas comerciais e, (3) sendo produzida a partir de tecidos neoplásicos variados, teoricamente pode apresentar seqüências relacionadas à tumorigênese. A metodologia foi eficiente na caracterização de um conjunto de genes diferencialmente expressos nas amostras de LMA, LLA, LMA subtipo M3 e dos casos-controle, pela análise estatística pelo método de Wilcoxon e clusterização hierárquica supervisionada e não-supervisionada desenvolvidas por Eisen. Na comparação entre LMA e LLA, sob o aspecto funcional, foi possível observar genes particularmente afetados relacionados a processos celulares específicos, como as vias de regulação do metabolismo de nucleotídeos, adesão e sinalização celulares (SS2XIP, MUC4, THBS1 e RGL2), transdução de sinal especialmente pela via Wnt e via Ras e Rho das ?small GTPases? (RGL2, ARGHAP1 e CDKN1B e beta-catenina) entre as LMA, e um conjunto de genes reguladores apoptóticos como os genes BIRC6, SH3GLB1, PSEN1 e NFKB1 entre as LLA. Os microarrays evidenciaram resultados importantes na separação de genes relacionados às LMA-M3 e às LMA-não M3, mostrando expressão diferencial de genes antes não associados ao subtipo específico M3, tais como TLE1, PSCDBP, SMG1, TALDO1, CUL1, TBX1 e UBXD8), alguns relacionados à regulação do ciclo celular e morte programada, e componentes do complexo Groucho/TLE que funciona como repressor da atividade transcricional induzida pela via Wnt.Os resultados foram validados através da utilização de PCR em tempo real em 5 genes selecionados e testados em uma população maior de casos (n=50 amostras de leucemias). Em 4 destes genes, os resultados foram completamente confirmados, demonstrando que a tecnologia de microarrays foi eficiente no rastreamento de genes potencialmente relacionados aos de subtipos de Leucemias Agudas, em especial as LLA e as LMA-M3, nesta membrana 3.7K do Instituto Ludwig/FAPESP. Assim, a utilização da metodologia de microarray com seqüências derivadas do Projeto genoma do Câncer (Instituto Ludwig/FAPESP) permitiu a discriminação de vias metabólicas importantes no processo de tumorigênese, alguns até mesmo associados a tipos leucêmicos específicos, e o reconhecimento de genes diferencialmente expressos antes não descritos na literaturaAbstract: The development of gene expression assays, such as cDNA microarrays, has permitted the simultaneous study of several genes; one of this methods is the cDNA microarrays. These investigations contribute to the classification of diseases, comprehension of tumoral biology and, finally, the determination of genetically related prognostic factors. In this present study, the gene expression profiles were analysed for 17 cases of Acute Myeloid Leukemia (AML), 5 cases of Acute Lymphocytic Leukemia (ALL) and 4 samples of peripheral blood apheresis, after stimulation with G-CSF for alogenic transplantation donors. For the microarray assays, membranes containing approximately 4700 spots were developed by the Ludwig Institute for Cancer Research, with contribution and financial support of FAPESP, using cDNA cloned from the Human Cancer Genome Project. The main advantages of these membranes include (1) availability of a cDNA library constructed by the ORESTES methodology, which makes the cDNA clones more representative of the whole transcriptome, (2) the non-comercial characterization of human transcripts, which may be vantageous for finding new genes and/or ESTs not diffusely disponible in large-scale production and, (3) since the library is contructed from different tumoral tissues, it may constitute the best representation of the tumorigenesis process. The methodology efficiently distinguished a group of genes, supporting the identification of the ALL, AML and control samples by the Wilcoxon Statistical Analysis and the supervised and non-supervised Hierarchical Clusterization developed by Eisen. Among the genes that were differentially expressed when comparing AML and ALL, it was possible to observe genes related to specific cellular processes such as: in the AML group nucleotides metabolism regulation pathways, adhesion and cell signaling (SS2XIP, MUC4, THBS1 e RGL2), signal transduction, especially in the Wnt pathway and Ras and Rho from the ?Small GTPases? pathway (RGL2, ARGHAP1, CDKN1B and beta-catenin), and in the ALL a group of apoptotic regulators genes such as BIRC6, SH3GLB1, PSEN1 e NFKB1 among. The microarray efficiently to distinguished genes related to M3-AML and non-M3-AML, showing differentially expressed genes not previosly described in the literature to be related to the specific sbtype M3-AML, such as TLE1, PSCDBP, SMG1, TALDO1, CUL1, TBX1, UBXD8, genes associated with programmed cell death and cell cycle, and components of Groucho/TLE complex, which functions like a repressor of transcriptional activity induced by the Wnt pathway. The results were validated through the utilization of Real Time PCR in five selected genes, tested in a greater number of cases (n=50 acute leukemia samples). In 4 of these genes the results were completely confirmed, demonstrating that the microarray technology with the 3.7K Ludwig Institut/FAPESP membranes was efficient for screening genes possibly related to specific leukemias subtypes, particularly the ALL and M3-AML groups. As such, the utilization of microarray methodology with sequences derived from the Cancer Genome Project (Ludwig Institut/FAPESP) permitted the distinction of important metabolic pathways for the tumorigenesis process, some of them associated to specific leukemic subtypes, and the recognition of differentially expressed genes not before described in the literatureDoutoradoBiologia Estrutural, Celular, Molecular e do DesenvolvimentoDoutor em Clínica Médic