Frailty-Independent Undertreatment Negative Impact on Survival in Older Patients With Breast Cancer

Purpose: The management of older adults with breast cancer (BC) remains controversial. The challenging assessment of aging idiosyncrasies and the scarce evidence of therapeutic guidelines can lead to undertreatment. Our goal was to measure undertreatment and assess its impact on survival. Methods: Consecutive patients with BC aged 70 years or older were prospectively enrolled in 2014. Three frailty screening tools (G8, fTRST, and GFI) and two functional status scales (Karnofsky performance score and Eastern Cooperative Oncology Group Performance Status) were applied. Disease characteristics, treatment options, and causes of mortality were recorded during a 5-year follow-up. In addition, we defined undertreatment and correlated its survival impact with frailty. Results: A total of 92 patients were included in the study. The median age was 77 (range 70-94) years. The prevalence of frailty was discordant (G8, 41.9%; fTRST, 74.2%; GFI, 32.3%). Only 47.8% of the patients had a local disease, probably due to a late diagnosis (73.9% based on self-examination). Thirty-three patients (35.6%) died, of which 15 were from BC. We found a considerably high proportion (53.3%) of undertreatment, which had a frailty-independent negative impact on the 5-year survival (hazard ratio [HR], 5.1; 95% confidence interval [CI], 2.1-12.5). Additionally, omission of surgery had a frailty-independent negative impact on overall survival (HR, 3.9; 95% CI, 1.9-7.9). Conclusion: BC treatment in older adults should be individualized. More importantly, assessing frailty (not to treat) is essential to be aware of the risk-benefit profile and the patient's well-informed willingness to be treated. Undertreatment in daily practice is frequent and might have a negative impact on survival, as we report.This article publication was supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia, I.P., within CINTESIS, R&D Unit (reference UIDB/4255/2020)

Magnetism and superconductivity driven by identical 4ff states in a heavy-fermion metal

The apparently inimical relationship between magnetism and superconductivity has come under increasing scrutiny in a wide range of material classes, where the free energy landscape conspires to bring them in close proximity to each other. This is particularly the case when these phases microscopically interpenetrate, though the manner in which this can be accomplished remains to be fully comprehended. Here, we present combined measurements of elastic neutron scattering, magnetotransport, and heat capacity on a prototypical heavy fermion system, in which antiferromagnetism and superconductivity are observed. Monitoring the response of these states to the presence of the other, as well as to external thermal and magnetic perturbations, points to the possibility that they emerge from different parts of the Fermi surface. This enables a single 4$f$ state to be both localized and itinerant, thus accounting for the coexistence of magnetism and superconductivity.Comment: 4 pages, 4 figure

Caracterização geoquímica e isotópica de depósitos sedimentares vulcanogénicos do Ordovícico Inferior do Sinclinal de Moncorvo, Nordeste de Portugal

Os ambientes geodinâmicos extensionais na Zona Centro Ibérica, durante o Ordovícico Inferior, favoreceram a ocorrência de episódios vulcânicos. No sinclinal de Moncorvo há evidências desses episódios, preservados sob a forma de depósitos sedimentares vulcanogénicos intercalados em metassedimentos da Formação Marão. Estes depósitos são essencialmente constituídos por quartzo, mas também contêm moscovite, fosfatos da série lazulite - scorzalite, zircão, monazite, raros opacos e turmalina. Embora os depósitos se apresentem recristalizados e com foliação metamórfica penetrativa, a sua granulometria fina, espessura (< 40 cm) e mineralogia sugerem que corresponderiam a depósitos de cinzas distais, com afinidade riodacítica, envolvendo a mistura com materiais detríticos. A datação U-Pb, obtida por ID-TIMS em zircão, indica uma idade preliminar de formação de 484.5 ± 3.0 Ma. Os elevados teores em alguns elementos incompatíveis, a razão CaO/Na2O de 0.33 a 1.77, perfis de REE com (La/Lu)N = 3.37 a 7.96 e discreta anomalia negativa de Eu, valores de (87Sr/86Sr)i t variáveis entre 0.71156 e 0.71304 e -10.8 e -10.0, respectivamente, indicam que os materiais vulcânicos teriam resultado da fusão parcial de metassedimentos semelhantes aos do Grupo do Douro e equivalentes do n orte da Zona Centro Ibérica. Porém, o envolvimento de processos sedimentares terá tido uma influência significativa na geoquímica elementar e isotópica destas rochas.The extensional geodynamic conditions in the Central Iberian Zone, during Lower Ordovician, were favorable to the occurrence of volcanic episodes. At the syncline of Moncorvo there are evidences of those episodes, which occur in the form of volcanogenic sedimentary deposits interbedded in the metasediments of Marão Formation. These deposits are mainly composed of quartz, but also contain muscovite, phosphates of the lazulite-scorzalite series, zircon, monazite, rare opaques and tourmaline. Despite the recrystallization and metamorphic foliation overprint, the fine -grained texture, the thickness (< 40 cm) and mineralogy of the deposits suggest that they correspond to distal ash -fall layers, with rhyodacitic to dacitic affinity, involving mixing with detrital materials. The U-Pb zircon dating, obtained by ID-TIMS, indicates a preliminary formation age of 484.5 ± 3.0 Ma. The high contents of some incompatible elements, the CaO/Na2O ratio between 0.33 and 1.77, the REE pattern with (La / Lu)N = 3.37 to 7.96 and slight negative Eu anomaly,(87Sr/86Sr)i and Ndt values variable between 0.71156 and 0.71304 and -10.8 and -10.0, respectively, indicate that the volcanogenic materials were derived from partial melting of metasediments similar to those of Douro Group and equivalents from northern Central Iberian Zone. However, the involvement of sedimentary processes may have had significant influence on elemental and isotopic geochemistry of these rocks

Bright conjugated polymer nanoparticles containing a biodegradable shell produced at high yields and with tuneable optical properties by a scalable microfluidic device

This study compares the performance of a microfluidic technique and a conventional bulk method to manufacture conjugated polymer nanoparticles (CPNs) embedded within a biodegradable poly(ethylene glycol) methyl ether-block-poly(lactide-co-glycolide) (PEG5K–PLGA55K) matrix. The influence of PEG5K–PLGA55K and conjugated polymers cyano-substituted poly(p-phenylene vinylene) (CN-PPV) and poly(9,9-dioctylfluorene-2,1,3-benzothiadiazole) (F8BT) on the physicochemical properties of the CPNs was also evaluated. Both techniques enabled CPN production with high end product yields (?70–95%). However, while the bulk technique (solvent displacement) under optimal conditions generated small nanoparticles (∼70–100 nm) with similar optical properties (quantum yields ∼35%), the microfluidic approach produced larger CPNs (140–260 nm) with significantly superior quantum yields (49–55%) and tailored emission spectra. CPNs containing CN-PPV showed smaller size distributions and tuneable emission spectra compared to F8BT systems prepared under the same conditions. The presence of PEG5K–PLGA55K did not affect the size or optical properties of the CPNs and provided a neutral net electric charge as is often required for biomedical applications. The microfluidics flow-based device was successfully used for the continuous preparation of CPNs over a 24 hour period. On the basis of the results presented here, it can be concluded that the microfluidic device used in this study can be used to optimize the production of bright CPNs with tailored properties with good reproducibility

Crystal-field effects in Er3+- and Yb3+-doped hexagonal NaYF4 nanoparticles

COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESCONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPSince the up-conversion phenomenon in rare-earths (REs) doped NaYF4 is strongly affected by the crystal electric field (CF), determining the CF parameters, wave functions, and scheme of the energy levels of the RE J multiplets could be crucial to improve and tune the up-conversion efficiency. In this work, the temperature and magnetic field dependent magnetization of NaY1-x[Er(Yb)](x)F-4 hexagonal nanoparticles (NPs) is reported. The data were best fit using the appropriated CF Hamiltonian for the J = 15/2 (J = 7/2) ground state multiplet of Er3+ (Yb3+) ions. The B-2(0), B-4(0), B-6(0), and B-6(6) CF parameters were considered in the Hamiltonian for RE ions located at the hexagonal C-3h point symmetry site of the NaYF4 host lattice. These results allowed us to predict an overall CF splitting of similar to 214 (similar to 356 K) for Er3+ (Yb3+) and the wave functions and their energy levels for the J = 15/2 (J = 7/2) ground state multiplet which are in good agreement with the low temperature electron spin resonance experiments. Besides, our measurements allowed us to calculate all the excited CF J multiplets that yield to a good estimation of the up-conversion light emission linewidth. The nonlinear optical light emission of the studied NaY1-x[Er(Yb)](x)F-4 hexagonal NPs was also compared with the most efficient up-conversion codoped NaY1-x-yErxYbyF4 hexagonal NPs.961617COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESCONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESCONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPSem informaçãoSem informação2011/19924-22012/04870-72012/05903-62015/23882-4This work was supported and performed under the auspices of the Brazilian agencies CAPES, CNPq, and FAPESP through Grants No. 2011/19924-2, No. 2012/04870-7, No. 2012/05903-6, and No. 2015/23882-4. The SEM data were acquired in the LNNano at the Centro Nacional de Pesquisa em Energia e Materiais (CNPEM) in Campinas-SP, Brazil. D.J.G. acknowledges support from FONCyT (PICT 2012-1069)