Respon Biologis pada Broiler yang diberikan Tepung Temulawak, Tepung Kencur dan Mineral Zink

Hasil penelitian menunjukkan bahwa pemberian tanaman herbal dan mineral Zinc berpengaruh nyata terhadap konsumsi ransum dan pertambahan bobot badan, namun tidak berpengaruh terhadap konversi randu

Ruth Tabancay interviewed by Maia Mislang

In this interview, originally recorded over Zoom, Ruth Tabancay speaks with Watsonville is in the Heart team member Maia Mislang. Ruth is a Bay Area-based textile and fiber artist. Ruth explains how her mother Esther Galicia immigrated to the United States from the Philippines to attend Hartnell College in Salinas. Esther's immigration to the US was sponsored by her aunt, Paula Galicia. Ruth discusses Esther's twenty-five years of experience working at Green Giant cannery in Watsonville. Ruth also explains that her father Benny Tabancay worked in the dry cleaning business rather than in the agricultural fields like many other men. Throughout the interview Ruth reflects on her time growing up within the Filipino American community in Watsonville, as well as how her identity and experiences impact her current art practice. She fondly recalls participating in Filipino folk dance classes, wearing traditional Filipiniana clothing, playing street games with neighborhood kids, and making decorations Fourth of July parade floats with her mother and other members of the Filipino Women's Club of Watsonville

Financial Stability Governance and Communication

Resumen de la comunicación[EN] We investigate how differences in governance frameworks across central banks explain their financial stability communication strategies and the effect of these strategies on the evolution of each country’s financial cycle. To do so, we propose a simple conceptual framework that explains how central banks conduct their communication strategy, which eventually affects the evolution of financial conditions. To empirically validate our framework, we use a database with the financial stability governance characteristics of 24 central banks and the sentiment conveyed in the financial stability reports published by these central banks. We find that, after observing a deterioration of financial conditions, central banks participating in interagency financial stability committees or with an oversight role transmit a calmer message than banks without these characteristics. We also find that the effect of communication on the evolution of the financial cycle depends on each central bank's governance framework. In particular, communication by central banks participating in an interagency financial stability committee or with a financial supervisory role has an alleviating effect on the deterioration of financial conditions.Londono, JM.; Claessens, S.; Correa, R.; Mislang, N. (2018). Financial Stability Governance and Communication. En 2nd International Conference on Advanced Reserach Methods and Analytics (CARMA 2018). Editorial Universitat Politècnica de València. 262-262. https://doi.org/10.4995/CARMA2018.2018.8577OCS26226

Nutritional management of older adults with gastrointestinal cancers: An International Society of Geriatric Oncology (SIOG) review paper

Available online 1 February 2018Malnutrition is one of the most common physical manifestations of gastrointestinal (GI) cancers and is often under-diagnosed and under-treated. Like cancers, malnutrition occurs more commonly in older adults, with potential negative consequences to quality of life, functional status, tolerance to treatment, and prognosis. Nutritional assessment and management require a proactive and systematic, multi-disciplinary approach. Early assessment, detection, and prompt intervention of cancer-associated malnutrition and cachexia are equally essential to achieve better quality nutritional care for older oncology patients. This article aims to provide an overview of the evidence associated with poor nutrition and outcomes in older adults with GI cancers, and recommends a management approach from a geriatric oncologist's perspective.Anna Rachelle Mislang, Samantha Di Donato, Joleen Hubbard, Lalit Krishna, Giuseppe Mottino, Federico Bozzetti, Laura Biganzol

Controversial issues in the management of older adults with early breast cancer

It is well recognized that the incidence of breast cancer increases significantly with age. Despite this, older people remain under-represented in many clinical trials and their management relies on extrapolation of data from younger patients. Providing an aggressive intervention can be challenging, particularly in less fit older patients where a conservative approach is commonly perceived to be more appropriate. The optimal management of this population is unknown and treatment decision should be personalized. This review article will discuss several controversial issues in managing older adults with early breast cancer in a multidisciplinary setting, including the role of surgical treatment of the axilla in clinically node negative disease, radiotherapy after breast conservation surgery in low-risk tumours, personalizing adjuvant systemic therapy, and geriatric assessments in breast cancer treatment decisions

Adequate assessment yields appropriate care—the role of geriatric assessment and management in older adults with cancer:a position paper from the ESMO/SIOG Cancer in the Elderly Working Group

With the aging population, older adults constitute a growing proportion of the new cancer cases. Given the heterogeneous health status among older adults and their susceptibility to aging-related vulnerabilities, understanding their diversity and its implications becomes increasingly crucial for prognostication and guiding diagnostics, treatment decisions, and follow-up, as well as informing supportive care interventions. Geriatric assessment and management (GAM) refers to the comprehensive evaluation of an older individual's health status with subsequent management plans focusing on both oncologic and non-oncologic interventions. In 2019, the European Society for Medical Oncology (ESMO) and the International Society of Geriatric Oncology (SIOG) established the ESMO/SIOG Cancer in the Elderly Working Group. This position paper reflects the recommendations of the working group. Our paper summarizes the existing evidence with a focus on recent key trials and based on this, we propose several recommendations and future directions.</p

EFFECT: a randomized phase II study of efficacy and impact on function of two doses of nab-paclitaxel as first-line treatment in older women with advanced breast cancer

Background: Limited data are available regarding the use of nab-paclitaxel in older patients with breast cancer. A weekly schedule is recommended, but there is a paucity of evidence regarding the optimal dose. We evaluated the efficacy of two different doses of weekly nab-paclitaxel, with a specific focus on their corresponding impact on patient function, in order to address the lack of data specifically relating to the older population. Methods: EFFECT is an open-label, phase II trial wherein 160 women with advanced breast cancer aged 65 65 years were enrolled from 15 institutions within Italy. Patients were randomly assigned 1:1 to receive nab-paclitaxel 100 mg/m2 (arm A) or 125 mg/m2 (arm B) on days 1, 8, and 15 on a 28-day cycle, as first-line treatment for advanced disease. The primary endpoint was event-free survival (EFS), wherein an event was defined as disease progression (PD), functional decline (FD), or death. In each arm, the null hypothesis that the median EFS would be 64 7 months was tested against a one-sided alternative according to the Brookmeyer Crowley test. Secondary endpoints included objective response rate (ORR), clinical benefit rate (CBR), progression-free survival (PFS), overall survival (OS), and safety. Results: After a median follow-up of 32.6 months, 140 events were observed in 158 evaluable patients. Median EFS was 8.2 months (90% CI, 5.9-8.9; p = 0.188) in arm A vs 8.3 months (90% CI, 6.2-9.7, p = 0.078) in arm B. Progression-free survival, overall survival, and response rates were similar in both groups. A higher percentage of dose reductions and discontinuations due to adverse events (AEs) was noted in arm B. The most frequently reported non-haematological AEs were fatigue (grade [G] 2-3 toxicity occurrence in arm A vs B, 43% and 51%, respectively) and peripheral neuropathy (G2-3 arm A vs B, 19% and 38%, respectively). Conclusion: Pre-specified outcomes were similar in both treatment arms. However, 100 mg/m2 was significantly better tolerated with fewer neurotoxicity-related events, representing a more feasible dose to be recommended for older patients with advanced disease. Trial registration: EudraCT, 2012-002707-18. Registered on June 4, 2012. NIH ClinicalTrials.gov, NCT02783222. Retrospectively registered on May 26, 2016

NUTMEG: A randomized phase II study of nivolumab and temozolomide versus temozolomide alone in newly diagnosed older patients with glioblastoma.

BACKGROUND: There is an immunologic rationale to evaluate immunotherapy in the older glioblastoma population, who have been underrepresented in prior trials. The NUTMEG study evaluated the combination of nivolumab and temozolomide in patients with glioblastoma aged 65 years and older. METHODS: NUTMEG was a multicenter 2:1 randomized phase II trial for patients with newly diagnosed glioblastoma aged 65 years and older. The experimental arm consisted of hypofractionated chemoradiation with temozolomide, then adjuvant nivolumab and temozolomide. The standard arm consisted of hypofractionated chemoradiation with temozolomide, then adjuvant temozolomide. The primary objective was to improve overall survival (OS) in the experimental arm. RESULTS: A total of 103 participants were randomized, with 69 in the experimental arm and 34 in the standard arm. The median (range) age was 73 (65-88) years. After 37 months of follow-up, the median OS was 11.6 months (95% CI, 9.7-13.4) in the experimental arm and 11.8 months (95% CI, 8.3-14.8) in the standard arm. For the experimental arm relative to the standard arm, the OS hazard ratio was 0.85 (95% CI, 0.54-1.33). In the experimental arm, there were three grade 3 immune-related adverse events which resolved, with no unexpected serious adverse events. CONCLUSIONS: Due to insufficient evidence of benefit with nivolumab, the decision was made not to transition to a phase III trial. No new safety signals were identified with nivolumab. This complements the existing series of immunotherapy trials. Research is needed to identify biomarkers and new strategies including combinations

Screening for frailty in older patients with early-stage solid tumors: a prospective longitudinal evaluation of three different geriatric tools

Advance Access publication February 2, 2017Background: Frailty increases the risk of adverse health outcomes and/or dying when exposed to a stressor, and routine frailty assessment is recommended to guide treatment decision. The Balducci frailty criteria (BFC) and Fried frailty criteria (FFC) are commonly used, but these are time consuming. Vulnerable Elders Survey-13 (VES-13) score of ≥7, a simple and resource conserving function-based scoring system, may be used instead. This prospective study evaluates the performance of VES-13 in parallel with BFC and FFC, to identify frailty in elderly patients with early-stage cancer. Methods: Patients aged ≥70 years with early-stage solid tumors were classified as frail/nonfrail based on BFC (≥1 criteria), FFC (≥3 criteria), and VES-13 (score ≥ 7). All patients were assessed for functional decline and death. Results: We evaluated 185 patients. FFC had a 17% frailty rate, whereas BFC and VES-13 both had 25%, with poor concordance seen between the three geriatric tools. FFC (hazard ratio = 1.99, p = .003) and VES-13 (hazard ratio = 2.81, p < .001) strongly discriminated for functional decline, whereas BFC (hazard ratio = 3.29, p < .001) had the highest discriminatory rate for deaths. BFC and VES-13 remained prognostic for overall survival in multivariate analysis correcting for age, tumor type, stage, and systemic treatment. Conclusions: A VES-13 score of ≥7 is a valuable discriminating tool for predicting functional decline or death and can be used as a frailtyscreening tool among older cancer patients in centers with limited resources to conduct a comprehensive geriatric assessment.Laura Biganzoli, Anna Rachelle Mislang, Samantha Di Donato, Dimitri Becheri, Chiara Biagioni, Stefania Vitale, Giuseppina Sanna, Elena Zafarana, Stefano Gabellini, Francesca Del Monte, Elena Mori, Daniele Pozzessere, Antonella Brunello, Andrea Luciani, Letizia Laera, Luca Boni, Angelo Di Leo, and Giuseppe Mottin