The Neutrophil-Lymphocyte Ratio is an Independent Prognostic Factor for Overall Survival in Hispanic Patients with Gastric Adenocarcinoma

Introduction High values of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are related with poor prognosis in patients with gastric cancer. However, this association has been rarely assessed in Hispanic populations that show important clinicopathological differences to Asian and Caucasian patients. In this study, we determined the prognostic value of these biomarkers in Hispanic patients from Costa Rica. Materials and Methods We retrieved data regarding pre-treatment NLR and PLR, as well as clinical variables from medical records of 381 consecutive gastric cancer patients treated in four major hospitals in Costa Rica between 2009 and 2012. Univariate and multiple Cox regression analyses were performed to assess the value of NLR and PLR as predictors of overall survival (OS) and disease-free survival (DFS). The best cutoff point was based on the maximization of the Log-rank test. Results Median follow-up was 13.21 months. In univariate analysis, a NLR ≥ 5 was associated with reduced DFS (hazard ratio (HR) 2.31; 95% confidence interval (CI) 1.78–3.00; p < 0.001) and poor OS (HR 2.24; 95% CI 1.72–2.92; p < 0.001). Similarly, a PLR ≥ 350 was associated with worse DFS (HR 2.28; 95% CI 1.70–3.06; p < 0.001) and poor OS (HR 2.33; 95% CI 1.73–3.13; p < 0.001). After adjustment for potential confounders, multivariate analysis revealed that only the NLR ≥ 5 was independently associated with worse DFS (HR 1.97; 95% CI 1.44–2.47) and OS (HR 1.59; 95%CI 1.15–2.28). Conclusions NLR ≥ 5 was independently associated with worse OS and DFS in Hispanic patients with gastric cancer.Universidad de Costa Rica/[817-B2-371]/UCR/Costa RicaUCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de MedicinaUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto de Investigaciones Farmacéuticas (INIFAR)UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Básicas::Centro de Investigación en Estructuras Microscópicas (CIEMIC

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

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UAV data for multi-temporal Landsat analysis of historic reforestation: a case study in Costa Rica

The use of the Landsat constellation to quantify historic deforestation and reforestation over time is well established. This analysis, however, requires ground-referenced data that is often inaccessible in remote areas or expensive if no existing high-resolution satellite imagery exists. In response, we evaluate the capability of unmanned aerial vehicle (UAV) imagery to serve as ground-reference data for identifying land-cover classes in Landsat imagery. We then apply these classes to quantify 30 years of historical deforestation and reforestation of an ecological reserve in Costa Rica. While spatial and spectral disparities between the sensors limit the generalization of the approach, our results demonstrate the ability of UAV and Landsat data to inexpensively classify a reserve\u27s historic land cover over time and suggest an 11 year period for land cover to transition from pasture to secondary forest in lowland tropical environments

Carbon and nutrient stocks of three Fabaceae trees used for forest restoration and subjected to fertilization in Amazonia

ABSTRACT Amazonia is crucial to global carbon cycle. Deforestation continues to be one of the main causes of the release of C into the atmosphere, but forest restoration plantations can reverse this scenario. However, there is still diffuse information about the C and nutrient stocks in the vegetation biomass. We investigated the carbon and nutrient stocks of Fabaceae trees (Inga edulis, Schizolobium amazonicum and Dipteryx odorata) subjected to fertilization treatments (T1 - no fertilization; T2 - chemical; T3 - organic; and T4 - organic and chemical fertilization) in a degraded area of the Balbina Hydroelectric Dam, AM - Brazil. As an early successional species, I. edulis stocked more C and nutrients than the other two species independent of the fertilization treatment, and S. amazonicum stocked more C than D. odorata under T1 and T4. The mixed species plantation had the potential to stock 4.1 Mg C ha-1 year-1, while I. edulis alone could stock 9.4 Mg C ha-1 year-1. Mixing species that rapidly assimilate C and are of significant ecological and commercial value (e.g., Fabaceae trees) represents a good way to restore degraded areas. Our results suggest that the tested species be used for forest restoration in Amazonia