Identification of Frailty using EMR and Admin data: A complex issue

Introduction Frailty is a state of vulnerability to diverse stressors emphasizing the importance of identifying the frail to support them. The burden of frailty in Canada is steadily growing. Today, approximately 25% of people over age 65 and 50% past age 85 – over one million Canadians – are medically frail. Objectives and Approach To develop an administrative data definition of frailty to facilitate clinical and health system planning. We will validate the definition by linking the administrative data to electronic medical records (EMR) data. The EMR definition is based on a Machine Learning binarized frailty flag for patients with a Rockwood Clinical Frailty Score > 5 on physician chart audit. The sensitivity of the Machine Learning was disappointing: 28% (95% CI: 21% to 36%).specificity was: 94% (95% CI: 93% to 96%), positive predictive value: 53% (95% CI: 42% to 64%), negative predictive value: 86% (95% CI: 83% to 88%). Results There was little overlap between the EMR and administrative data definitions using the same population. Of the 29,382 eligible administrative data community dwelling patients over 65 years old, with a linkable EMR record, 2398 (8.15%) were identified as frail using the administrative data definition, but only 16.1% of these were frail according to the EMR definition. Of the 2396 who were identified as frail in EMR data, only 375 (15.7%) were identified as frail using the administrative data definition. Conclusion/Implications We are not yet able to develop a reliable administrative data definition of frailty to identify community living individuals to support health service planning. The lack of agreement between the results obtained from EMR and administrative data definitions suggests that further refinement is necessary. Identification of frailty remains complex

An Integrated Space Environment Analysis Tool (SEAT)

This paper describes an integrated, comprehensive tools for analysis of environmental related spacecraft hazards for use in spacecraft analysis and design, mission planning and operations. This analysis is extremely important for small satellites since they are often at higher risk due to a number of physical, economic and operational constraints. These constraints may limit the ability to mitigate the natural and man-made hazards resulting from the space environments the satellite will be operating in. The SEAT software tool addresses hazards and effects related to solar activity, magnetic fields, radiation. thermal exposure, impact from small particles, plasma and neutral atmosphere exposure. SEAT is integrated with a commercial-off-the-shelf orbit analysis package. It is designed to be useable by spacecraft engineers and operators who may not have expertise in space environmental effects and their analysis

Cruciferous vegetable feeding alters UGT1A1 activity: diet- and genotype-dependent changes in serum bilirubin in a controlled feeding trial.

Chemoprevention by isothiocyanates from cruciferous vegetables occurs partly through up-regulation of phase-II conjugating enzymes, such as UDP-glucuronosyl-transferases (UGT). UGT1A1 glucuronidates bilirubin, estrogens, and several dietary carcinogens. The UGT1A1*28 polymorphism reduces transcription compared to the wild-type, resulting in decreased enzyme activity. Isothiocyanates are metabolized by glutathione-S-transferases (GST); variants may alter isothiocyanate clearance, such that response to crucifers may vary by genotype. We evaluated, in a randomized, controlled, cross-over feeding trial in humans (n=70), 3 test diets, (single- and double-“dose” cruciferous and cruciferous plus apiaceous) compared to a fruit-and-vegetable-free basal diet. We measured serum bilirubin concentrations on days 0, 7, 11 and 14 of each 2-week feeding period to monitor UGT1A1 activity, and determined effects of UGT1A1*28 and GSTM1/GSTT1-null variants on response. Aggregate bilirubin response to all vegetable-containing diets was statistically significantly lower compared to the basal diet (p<0.03 for all). Within each UGT1A1 genotype, lower bilirubin concentrations were seen in: *1/*1 in both single and double-dose cruciferous diets compared to basal (p<0.03 for both); *1/*28 in double-dose cruciferous and cruciferous plus apiaceous compared to basal, and cruciferous plus apiaceous compared to single-dose cruciferous (p<0.02 for all); and *28/*28 in all vegetable-containing diets compared to basal (p<0.02 for all). Evaluation of the effects of diet stratified by GST genotype revealed some statistically significant genotypic differences however, the magnitude was similar and not statistically significant between genotypes. These results may have implications for altering carcinogen metabolism through dietary intervention, particularly among UGT1A1*28/*28 individuals

Modulation of human serum glutathione S-transferase-A1/2 concentration by cruciferous vegetables in a controlled feeding study is influenced by GSTM1 and GSTT1 genotypes

Glutathione S-transferases (GST) detoxify a wide range of carcinogens. Isothiocyanates (ITC), from cruciferous vegetables, are substrates for, and inducers of GST. GST variants may alter ITC clearance such that response to crucifers varies by genotype. In a randomized cross-over trial, we tested the hypothesis that changes in serum GSTA1/2 concentration in response to cruciferous vegetable feeding depends on GSTM1/GSTT1 genotype. Thirty-three men and 34 women (age 20-40 yr), ate four 14-day controlled diets: basal (vegetable-free), basal supplemented with 2 different doses of crucifers, (single-“dose” and double-“dose”) and single-dose cruciferous-plus-apiaceous vegetables, fed per kg body weight. Fasting bloods from days 0, 7, 11, and 14 of each diet period were analyzed for serum GSTA1/2 by ELISA. GSTA1/2 increased with single- and double-dose cruciferous compared to basal diet (10% and 13%, respectively; P = 0.02 and 0.004), but cruciferous-plus-apiaceous did not differ from basal (P = 0.59). Overall, GSTA1/2 was higher in GSTM1-null/GSTT1-null than GSTM1+/GSTT1+ individuals (4198 ± 338 and 3372 ± 183 pg/ml; P = 0.03). The formal interaction of genotype-by-diet was not statistically significant, but the GSTA1/2 increase during the single-dose cruciferous diet was among GSTM1-null/GSTT1-null individuals (by 28%; P = 0.008), largely explained by GSTM1-null/GSTT1-null men (by 41%; P = 0.01). GSTA1/2 increased during the double-dose cruciferous diet in both GSTM1-null/GSTT1-null men (by 35 %; P = 0.04) and GSTM1+/GSTT1+ men (by 26%; P = 0.01), but not in women. In summary, cruciferous vegetable supplementation increased GSTA1/2, but the effect was most marked in GSTM1-null/GSTT1-null men

Inquérito sorológico e molecular de Leptospira spp. em cavalos carroceiros de área endêmica para leptospirose humana em Curitiba, Sul do Brasil

Introdução: Cavalos carroceiros são uma população reemergente empregada para transportar materiais recicláveis em cidades. Métodos: Em área endêmica para leptospirose humana foram amostrados 62 cavalos. Soroaglutinação microscópica e reação em cadeia da polimerase em tempo real foram empregadas. Resultados: Observou-se soropositividade em 75,8% com sorovar Icterohaemorrhagiae em 80,8% cavalos. Amostras de sangue e urina foram negativas no qPCR. Observou-se correlação positiva entre SAM e pluviosidade (p = 0,02) e alagamentos (p = 0,03). Conclusão: Embora cavalos possam estar constantemente expostos a Leptospira spp. no ambiente, principalmente por chuvas e inundações, leptospiremia e leptospiruria não foram encontradas neste estudo.Introduction: Cart horses are a re-emerging population employed to carry recyclable material in cities. Methods: Sixty-two horses were sampled in an endemic area of human leptospirosis. The microscopic agglutination test (MAT) and real-time polymerase chain reaction (qPCR) were performed. Results: A seropositivity of 75.8% with serovar Icterohaemorrhagiae in 80.8% of the horses was observed. Blood and urine were qPCR negative. MAT showed positive correlations with rainfall (p = 0.02) and flooding (p = 0.03). Conclusions: Although horses may be constantly exposed to Leptospira spp. in the environment mostly because of rainfall and flooding, no leptospiremia or leptospiruria were observed in this study

ISOLAMENTO, CARACTERIZAÇÃO E SELEÇÃO DE MICRORGANISMOS PROMOTORES DE CRESCIMENTO VEGETAL DE VITIS SP.

As bactérias promotoras de crescimento em plantas (BPCPs) colonizam a rizosfera e os tecidos das plantas e atuam tanto pelo controle biológico de fitopatógenos como diretamente pela promoção de crescimento, aumentando a produtividade e diminuindo a necessidade de utilização de produtos químicos fertilizantes e fungicidas. Neste trabalho teve-se por objetivo a bioprospecção de bactérias como agentes promotores de crescimento vegetal e biocontrole de patógenos, visando à formulação de um bioproduto. Foram isolados microrganismos provenientes de amostras de solo, em diferentes propriedades da região do Meio-Oeste de Santa Catarina. Após, avaliados quanto à produção de sideróforos, solubilização de fosfato, produção de ácido indol acético, fixação assimbiótica de nitrogênio atmosférico, produção de celulase, foram selecionados e inoculados em substrato para avaliar o efeito sobre o crescimento da videira. Os experimentos foram conduzidos em casa de vegetação e realizados com cinco tratamentos e um grupo controle: T1 = controle, T2-T5 = uma bactéria cada e T6 = um consórcio). Uma suspensão contendo 108 UFC/mL foi inoculada em estacas enraizadas de porta-enxertos de videira da variedade Paulsen 1103 (aclimatização por 30 dias). Para cada tratamento foram empregados 25 vasos com as estacas enraizadas, sendo avaliados por 60 dias e verificando-se em intervalos regulares à concentração de clorofila foliar, comprimento do ramo, número de folhas. Ao final foram verificadas a biomassa fresca e a biomassa seca. Foram isoladas 47 bactérias, destas, 87% produziram ácido indol acético, 58,7% produziram sideróforos, 54,3% solubilizaram fosfato, 30% fixaram nitrogênio, 34,8% produziram celulase e 9% apresentaram atividade contra o fungo fitopatogênico. Segundo análises estatísticas não houve diferença entre os tratamentos, quanto à biomassa fresca e seca. Os resultados das avaliações in vitro demonstram o potencial biotecnológico das bactérias como agentes de promoção do crescimento vegetal, sendo uma alternativa para a elaboração de um bioproduto.Palavras-chave: Bactéria. Promoção crescimento vegetal. Bioprospecção

POTENCIAL ANTIMICROBIANO IN VITRO DE ISOLADOS DE ACTINOBACTÉRIAS A FITOPATÓGENOS DA CULTURA DO TOMATEIRO

As actinobactérias têm sido estudadas para utilização na agricultura e indústria farmacêutica em razão da sua capacidade de produzir metabólitos secundários com diversas atividades biológicas. Objetivou-se com este trabalho isolar actinobactérias de solo rizosférico e raízes de diferentes espécies vegetais e avaliar a atividade antimicrobiana frente a fitopatógenos da cultura do tomateiro. O isolamento de actinobactérias foi realizado de amostras raízes e solo rizosférico de plantas de maçã, nectarina, cebola e alho. As amostras foram submetidas a diluições decimais seriadas e plaqueamento em meio ágar-amido-caseína (ACA) adicionado ou não de ciclohexamida (100µg/mL). As placas semeadas foram incubadas a 30 ºC, por quatro a sete dias. Após a incubação, as colônias com morfologia característica de actinobactéria foram transferidas para o meio ACA. A atividade antimicrobiana de 155 isolados de actinobactérias foi testada frente a cinco fitopatógenos de tomateiro: Xanthomonas campestres pv. vesicatoria, Pseudomonas syringae pv. tomato, Ralstoia solanacearum, Alternaria solani e Fusarium oxysporum f. sp. Lycopersici e foi determinada pela técnica de dupla camada. Para o adequado desenvolvimento de cada microrganismo foi utilizado período de incubação e meios de cultivo específicos para cada espécie. O índice de antibiose (IA) foi obtido pela equação: IA = média do diâmetro do halo - média diâmetro da colônia. Os ensaios foram realizados em triplicata. No total, foram isolados 155 actinobactérias de solo rizosférico, sendo 68 de plantas de maçã, 20 de nectarina, 41 de cebola e 26 de alho. No ensaio de dupla camada, 28% dos isolados de actinobactérias apresentaram atividade antibacteriana e 16%, atividade antifúngica. Destes, pelo menos 7,9% mostraram atividade antimicrobiana, com IA superior a 20 mm, frente aos fitopatógenos testados. A exceção foi observada para a atividade antifúngica à A. solani, para a qual apenas 1,93% das actinobactérias apresentou esse IA. Conclui-se que os isolados de actinobactérias apresentam potencial para utilização no controle de fitopatógenos do tomateiro.Palavras-chave: Actinobactéria antagonista. Atividade antimicrobiana. Controle biológico

The historical value of the Malqui-Machay farms and its impact on the contribution of the Cultural Identity of the Canton La Maná

Introducción. Las haciendas Malqui-Machay ubicadas en la parroquia de Guasaganda, cantón la Maná, posee vestigios arqueológicos mismos que se los conocen como la última morada del Inca Atahualpa por los sucesos históricos que han sido de importancia para la historia ecuatoriana ya que habría sido el refugio de los últimos Incas. Estos acontecimientos son un aporte para la identidad cultural del sector gracias a la historia que posee, Sin embargo, presenta debilidades en la conservación de la arqueología y con ello la identidad cultural de la población Lamanense, esto ha sido consecuencia de la devaluación de la infraestructura y por las condiciones climáticas. Objetivo. &nbsp;Preservar el valor histórico de las haciendas Malqui-Machay y su incidencia en la identidad cultural del cantón La Maná. Metodología. Para la presente investigación se trabajó con una muestra de 69 personas en donde se tomó la opinión de profesionales, propietarios de las haciendas y la población de la parroquia de Guasaganda, esta información fue levantada a través de salidas de campo mediante las técnica de la entrevista (5) y encuesta (64),mismas que fueron formuladas con interrogantes estructuradas cerradas; El propósito principal fue recabar información para conocer el criterio y el conocimiento de los pobladores acerca de los hitos históricos que sucedieron en las haciendas Malqui-Machay. Resultados. Según el estudio de la identidad cultural realizado en las haciendas Malqui-Machay se enmarcan importantes resultados ya que estos sitios fortalecen las costumbres y tradiciones de la población gracias a los acontecimientos de cada hacienda y las leyendas existentes en la zona circundante. Con estos datos positivos se procede a realizar el diseño de una guía informativa de patrimonio cultural la cual contenga tres secciones: informativa, leyendas y conservación. Con el propósito fundamental de rescatar parte de la identidad cultural de los habitantes del cantón La Maná. Conclusión. Dentro de las haciendas Malqui-Machay existe un gran potencial turístico cultural el cual aporta en la identidad cultural de los habitantes de la parroquia Guasaganda Cantón La Maná ya que se encuentra una arqueología que se desarrollaron gracias, a los acontecimientos y a la memoria histórica que se han evidenciado en dicho lugar y a las leyendas que han prevalecido en el tiempo y que son un icono para el sector.&nbsp;&nbsp;Introduction. The Malqui-Machay farms located in the parish of Guasaganda, La Maná Canton, have archaeological remains that are known as the last dwelling place of the Inca Atahualpa due to the historical events that have been of importance for Ecuadorian history since it would have been the refuge of the last Incas. These events are a contribution to the cultural identity of the sector thanks to the history it has. However, it has weaknesses in the conservation of archeology and with it the cultural identity of the Lamanense population, this has been a consequence of the devaluation of the infrastructure and by weather conditions. Objective. Preserve the historical value of the Malqui-Machay estates and their impact on the cultural identity of the La Maná Canton. Methodology. For this research, we worked with a sample of 69 people where the opinion of professionals, owners of the haciendas and the population of the Guasaganda parish was taken, this information was collected through field trips using the interview techniques (5) and survey (64), which were formulated with closed structured questions; The main purpose was to gather information to know the criteria and knowledge of the inhabitants about the historical milestones that happened in the Malqui-Machay estates. Results. According to the study of cultural identity carried out in the Malqui-Machay haciendas, important results are framed, since these sites strengthen the customs and traditions of the population thanks to the events of each hacienda and the legends existing in the surrounding area. With these positive data, we proceed to design an informative cultural heritage guide which contains three sections: informative, legends and conservation. With the fundamental purpose of rescuing part of the cultural identity of the inhabitants of Canton La Maná. Conclusion. Within the Malqui-Machay farms there is a great potential for cultural tourism which contributes to the cultural identity of the inhabitants of the Guasaganda Canton La Maná parish since there is an archeology that was developed thanks to the events and historical memory that have been evident in that place and the legends that have prevailed over time and are an icon for the sector.&nbsp;&nbsp

PROMOÇÃO DE CRESCIMENTO DE PLANTAS DO PORTA-ENXERTO DE VIDEIRA PAUSEN 1103 POR BACILLUS

A cultura da videira (Vitis sp.) tem um papel importante na agricultura mundial e brasileira, sendo matéria-prima para diversos produtos.O emprego de bactérias promotoras de crescimento em plantas (BPCP) constitue uma alternativa viável para promoção do crescimento vegetal. Considerando o potencial microbiano, o objetivo desse trabalho foi avaliar o efeito da inoculação de microrganismos sobre o desenvolvimento da variedade de porta-enxerto de videira Paulsen 1103. Para este trabalho foram empregadas três isolado: Bacillus amyloliquefaciens, B. thuringiensis e Streptomyces sp. O delineamento experimental constitui-se de seis tratamentos , o T1: Streptomyces; T2: controle meio Streptomyces; T3: B. Bacillus amyloliquefaciens, T4:B. thuringiensis; T5: controle meio Bacillus e T6: controle com água. Uma suspensão bacteriana contendo 1,8 X 108 UFC/ml da bactéria teste foi adicionada ao substrato das estacas enraizadas. As estacas foram mantidas em casa de vegetação com controle da temperatura, umidade e fotoperíodo. Ao 15° dia foi realizado uma segunda inoculação. Semanalmente foi determinado, o comprimento dos ramos e o número de folhas. Aos 60 dias foi determinada a massa fresca, a seca e teor de nutrientes. Os resultados obtidos mostraram um aumento de 62% e 28% no crescimento da videira com o tratamento com B. thuringiensis e com B amyloliquefaciens, respectivamente. O número médio de folhas foi maior em plantas  inoculadas com Bacillus. .Foi observada diferença significativa em relação aos teores de  N e Ca, nos tratamentos com inoculação se comparados aos controles

Cross-Jurisdictional Analysis of Administrative Health Data and Primary Care Electronic Medical Records in Canada

Over the last 30 years, public investments have created and supported administrative health data resources and repositories in Canada to support population health, health services and health policy research. Together, these repositories represent the building blocks of a world-class data platform that enables evidence-informed clinical, managerial and policy decisions. But because Canada’s universal health care system is managed at the provincial level, these repositories have limited capacity to share and use data across jurisdictional boundaries. Challenges with timely access to data remain and differences between jurisdictions affect the quality, scope, and impact of work that could be done. There are considerable benefits to be obtained from collaboration seeking to compare and/or combine health data across jurisdictional borders, despite the limitations in sharing the data. To ensure that Canadians continue to have access to high-quality health care and benefit from effective health policies, researchers and system planners must have access to and be able to make effective use of administrative health data. The purpose of this paper is to describe how we approached and addressed challenges in data access, data governance and data architecture in a Canadian cross-jurisdictional research study