The dialyzable transfer factor (TF) was prepared from spleen and lymph node cells of either normal (TFn) or infected (TFi) mice with Trypanosoma cruzi. The ability of TFn and TFi in transferring cellular immunity to T. cruzi antigens was assessed by the macrophage migration inhibition assay and lymphocyte transformation test. The results obtained with these two immunological assays indicated that only TFi is able to transfer cellular immune responses. This phenomenon was antigen specific. The content of free amino acids in TFi preparation was higher than in TFn. However, our data indicated that the stimulation of lymphocyte transformation is not due to the increase in glycine and serine. This activity of TFi required the addition of T. cruzi antigens. Our findings support the hypothesis that TFi is derived from immune RNA.

Purpose: To identify the interrelations among determinants of multidimensional frailty, physical frailty, and their individual components. Methods: A group of 1024 community-dwelling people older than 65 years completed questionnaires regarding: multidimensional frailty (Tilburg Frailty Indicator, TFI) and physical frailty (FRAIL scale), and common frailty risk factors. Results: Multidimensional frailty was recognized in 559 subjects (54.6%) and determined by 13 factors (R² = 0.21 in logistic regression). After incorporating TFI components to the models, the majority of previous risk factors became non-essential, and the frailty deficits mainly determined each other with R² ranging between 0.07-0.67. Physical frailty and non-robust status (i.e., either physical frailty or pre-frailty) were recognized in 64 (6.3%) and 542 (52.9%) participants, and were determined by 5 factors (R² = 0.33) and 11 factors (R² = 0.34), respectively. Associations between the frailty deficits were detected within and between different dimensions (i.e., physical, psychological and social); the physical domain was mainly related to the psychological one which in turn was additionally associated with the social one. Conclusion: Frailty is the accumulation of deficits and is determined by factors other than the determinants of the individual deficits. The associations between deficits coming from various dimensions of human functioning presumably amplify their effects and accelerate frailty development.

Keywords: FRAIL scale; Tilburg Frailty Indicator; determinants; frailty; non-robust.

The nuclear receptor COUP TFI (also known as Nr2f1) plays major roles in specifying distinct neuronal subtypes during patterning of the neocortical motor and somatosensory cortex, as well as in regulating the longitudinal growth of the hippocampus during development. In humans, mutations in the NR2F1 gene lead to a global developmental delay and intellectual disabilities. While more than 30% of patients show behavioral features of autism spectrum disorder, 16% of haploinsufficient children show signs of hyperactivity and impulsivity. Loss of COUP-TFI in the cortical mouse primordium results in altered area organization and serotonin distribution, abnormal coordination of voluntary movements and learning and memory deficits. Here, we asked whether absence of COUP-TFI affects locomotor activity, anxiety, as well as depression. Mice mutant for COUP-TFI have normal motor coordination, but significant traits of hyperactivity, which does not seem to respond to N-Methyl-D-aspartate (NMDA) antagonists. However, no changes in anxiety, despite increased locomotor performances, were observed in the open field task. On the contrary, elevated plus maze and dark-light test explorations indicate a decreased anxiety-like behavior in COUP-TFI mutant mice. Finally, significantly reduced immobility in the forced swim test and no changes in anhedonia in the sucrose preference task suggest no particular depressive behaviors in mutant mice. Taken together, our study shows that loss of COUP-TFI leads to increased locomotor activity but less anxiety and contributes in further deciphering the pathophysiology of patients haploinsufficient for NR2F1.

Oligoamines which exert antiplatelet and anticoagulant properties in vitro show as well antithrombotic effects in mesenteric arterioles and venoles of rats. The formation of thrombi in these vessels was induced by a laser beam and quantified by the thrombus formation index (TFI). The most potent compound RE 1492 already reduced the formation of thrombi after i.v. administration of 1 mg/kg significantly. After oral administration, however, only a minor effect even after a 200 mg/kg dose is observed. This suggests that the oligoamine was poorly absorbed from the gastrointestinal tract. The tricarbamate of RE 1492 (identical to RE 1492 C), however, was a suitable prodrug. Eight hours after a single oral dose of 10 mg/kg significant antithrombotic properties in arterioles and venules were seen. (TFI = 3.63 (A), 1.77 (V); control: 1.76 (A), 1.29 (V).) After p.o. application of 30 mg/kg RE 1492 C the onset of activity is after 2 h (TFI = 3.44/1.48). A maximum effect is reached after 4 h (TFI: 4.43/2.84) and maintained up to 24 h (TFI = 4.49/2.45). After 48 h the effect in arterioles is still significant (p less than 0.05, chi 2-test). The results obtained with five other carbamates (RE 2029 C, RE 1964 C, RE 2120 C, RE 2112 C, and RE 1981 C) 4 h after p.o. administration in general show a stronger effect in arterioles than in venules which is in the same range as in RE 1492 C.

Many anti-inflammatory agents have been exploited for the treatment of inflammatory diseases by targeting the most potent proinflammatory cytokines including tumor necrosis factor (TNF) and interleukin-1 (IL-1). Theoretically, simultaneous neutralization or blocking two important inflammatory mediators might achieve a synergistic therapeutic effect. A recombinant fusion protein, TNFR2-Fc-IL-1ra (TFI), was developed as bifunctional inflammatory inhibitor. TFI was able to strongly neutralize TNF activity and to antagonize IL-1 receptor in the cell binding inhibition assays, suggesting that TFI could be used as a bifunctional ligand with enhanced anti-inflammatory effect.

Objectives: The tinnitus functional index (TFI) is becoming a new international gold standard for tinnitus assessment. This study aimed to evaluate the efficacy of hearing aids for chronic tinnitus, using the Japanese version of the TFI, while focusing on its subscales.

Materials and methods: This is a retrospective study. A total of 21 patients with chronic tinnitus were included. All participants were treated with hearing aids for at least 12 months. They answered the TFI and tinnitus handicap inventory (THI) at the first visit and 12 months later. We analyzed each TFI subscale score and the overall scores of TFI and THI.

Results: The overall TFI score decreased significantly after treatment (p=0.005) with moderate effect size (d=0.70). The scores of the intrusive, sense of control, sleep, and emotional subscales decreased significantly after the treatment. Large effect sizes were found in the intrusive and sense of control subscales (d=1.33 and d=1.25, respectively).

Conclusion: Hearing aids are highly effective for improving the intrusive and sense of control subscales in patients with tinnitus. Identifying better treatments for the small effect size subscales and combining these with the use of hearing aids could achieve a higher therapeutic effect with better outcomes.

The TFI-musculofasciocutaneous flap has become a standard procedure in recent years. Donor-site problems of this method, especially the biomechanical changes of the hip, the proximal femur and the knee joint are evaluated, employing biomechanical techniques. Harvesting of a TFL-flap leads to functional loss of the M. tensor fasciae latae and the iliotibial tract and band. This might lead to a weakening of active and passive stabilising structures of the hip and the knee joint. Loss of the iliotibial tract causes a loss of the lateral tension-band of the proximal femur and leads to a significant increase of shear forces on the proximal femoral shaft. The functionally important structures of the iliotibial tract for knee biomechanics are not influenced by harvesting of the TFL flap. Loss of the M. tensor fasciae latae leads to a mild reduction of hip flexion and internal rotation. The indication for a TFL-flap should consider the patient's activity to prevent overload damage of the proximal femoral shaft. In childhood, harvesting of the TFL flap is likely to influence the growing axial skeleton due to the loss of the iliotibial tract.

Development of the dentate gyrus (DG), the primary gateway for hippocampal inputs, spans embryonic and postnatal stages, and involves complex morphogenetic events. We have previously identified the nuclear receptor COUP-TFI as a novel transcriptional regulator in the postnatal organization and function of the hippocampus. Here, we dissect its role in DG morphogenesis by inactivating it in either granule cell progenitors or granule neurons. Loss of COUP-TFI function in progenitors leads to decreased granule cell proliferative activity, precocious differentiation and increased apoptosis, resulting in a severe DG growth defect in adult mice. COUP-TFI-deficient cells express high levels of the chemokine receptor Cxcr4 and migrate abnormally, forming heterotopic clusters of differentiated granule cells along their paths. Conversely, high COUP-TFI expression levels downregulate Cxcr4 expression, whereas increased Cxcr4 expression in wild-type hippocampal cells affects cell migration. Finally, loss of COUP-TFI in postmitotic cells leads to only minor and transient abnormalities, and to normal Cxcr4 expression. Together, our results indicate that COUP-TFI is required predominantly in DG progenitors for modulating expression of the Cxcr4 receptor during granule cell neurogenesis and migration.

BACKGROUND

The clinical features and principles of surgery of the Ascending Testis (AT), in which the testis ascends from the scrotum with age, are controversial. We selected AT that met the treatment guidelines and examined the clinical features and principles of surgery.

METHODS

We retrospectively reviewed the medical charts of 12 AT and 530 Congenital Undescended Testis (CUDT) patients to investigate the statistics of AT among all CUDT, the side of the maldescent, the associated disorders, and the clinical course. The patients were compared in terms of testicular volume (TV), mean tubular diameter (MTD), and testicular fertility index (TFI) between the AT group and the CUDT group.

RESULTS

AT was observed in 2.2% of all CUDT patients: 10 had left AT and 2 had bilateral AT. Among the 12 AT patients, 8 patients had associated disorders. The TV, MTD, and TFI of 7 AT and 7 CUDT were 0.74 +/- 0.20 and 0.77 +/- 0.59 cm3, 38.7 +/- 3.7 and 35.9 +/- 9.1 microm, and 0.19 +/- 0.07 and 0.11 +/- 0.11, respectively.

CONCLUSIONS

In order to examine the clinical features of AT, it is essential to strictly rule out CUDT and retractile testis. In our study, the clinical features are that AT is a rare disorder, occurs more frequently on the left side, and many patients with AT have associated disorders. Since AT causes histological damage equivalent to that caused by CUDT, we should perform orchidopexy for patients with AT immediately after diagnosis.

We aimed to assess the validity and reliability of the ten-item Connor-Davidson Resilience Scale (CD-RISC10) in patients with axial spondyloarthritis (axSpA) in Singapore. We used cross-sectional data from 108 patients with axSpA recruited from a dedicated axSpA clinic in a Singapore tertiary referral hospital from 2017 to 2018. Analyses were guided by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) framework. Face validity was assessed through cognitive debriefing interviews (CDIs). Internal consistency was assessed through Cronbach's alpha. Test-retest reliability was assessed through intraclass correlation (ICC). Measurement error was assessed through smallest detectable change (SDC). Construct validity was assessed through six a priori hypotheses through correlation of the CD-RISC10 score with other patient-reported outcome measures. Structural validity was assessed using confirmatory factor analysis (CFA). Fit indices evaluated were root-mean-square error of approximation (RMSEA), comparative fit index (CFI), Tucker-Lewis index (TFI), and standardized root-mean-squared residual (SRMR). Ten patients completed the CDIs and face validity was supported. Among 108 patients (median age: 37(21-77), 81.5% males, 93.5% Chinese), the CD-RISC10 demonstrated good internal consistency (Cronbach's alpha = 0.94), and excellent test-retest reliability [ICC = 0.964 (95% CI 0.937-0.980)]. SDC was calculated as 1.88. Construct validity was established by meeting five out of the six a priori hypotheses. Structural validity was supported as CFA confirmed a one-factor model, with adequate fit statistics after adding three covariances (RMSEA = 0.077; CFI = 0.975; TLI = 0.964; SRMR = 0.036). This study supports the CD-RISC10 as a valid and reliable measure of resilience for use in patients with axSpA.

In the increasingly complex electromagnetic environment of modern battlefields, how to quickly and accurately identify radar signals is a hotspot in the field of electronic countermeasures. In this paper, USRP N210, USRP-LW N210, and other general software radio peripherals are used to simulate the transmitting and receiving process of radar signals, and a total of 8 radar signals, namely, Barker, Frank, chaotic, P1, P2, P3, P4, and OFDM, are produced. The signal obtains time-frequency images (TFIs) through the Choi-Williams distribution function (CWD). According to the characteristics of the radar signal TFI, a global feature balance extraction module (GFBE) is designed. Then, a new IIF-Net convolutional neural network with fewer network parameters and less computation cost has been proposed. The signal-to-noise ratio (SNR) range is -10 to 6 dB in the experiments. The experiments show that when the SNR is higher than -2 dB, the signal recognition rate of IIF-Net is as high as 99.74%, and the signal recognition accuracy is still 92.36% when the SNR is -10 dB. Compared with other methods, IIF-Net has higher recognition rate and better robustness under low SNR.

The gene encoding Thermus filiformis (Tfi) DNA polymerase was expressed under the control of the tac promoter on a high-copy plasmid, pJR, in Escherichia coli. The Tfi DNA polymerase was purified by using heat treatment and DEAE-Sephacel column chromatography. The purified enzyme had a molecular mass of 92 kDa, as estimated by SDS/PAGE. The optimum pH and temperature of the enzyme were 8.4-9.0 and 70-72.5 degrees C respectively. The half-life of the enzyme at 94 degrees C was approx. 40 min. The enzyme was activated by the bivalent cations, Mg(2+) and Mn(2+), and was inhibited by EDTA. The optimal Mg(2+) concentration of the enzyme was 4 mM. The optimal conditions for the PCR reaction were slightly different from those for the enzyme activity except for the optimal Mg(2+) concentration. Low concentrations of KCl had no effect on either the enzymic activity or the PCR amplification. The result of the PCR experiment with the enzyme indicates that Tfi DNA polymerase might be useful in DNA amplification.

TNM classification allows only a partial estimation of future tumour behaviour after surgery. More knowledge on malignant potential is needed. Spreading of viable tumour cells during transurethral resection (TUR) and their possible subsequent implantation in the bladder mucosa should be an important factor influencing duration of the tumour-free interval (TFI). A total of 1384 fresh urine samples sequentially taken after surgery from 356 patients were examined in a cytological laboratory. Data analysis confirmed significant differences in TFI between the groups with negative, suspicious and positive cytology. The higher the cytological abnormalities the shorter was TFI, regardless of which histopathological tumour grade has been verified.

The purpose of our study was to evaluate the relative impact of bivalirudin on bleeding outcomes associated with trans-radial interventions (TRI) in real world practice.

Data for patients undergoing percutaneous coronary intervention (PCI) between January 2010 and March 2014 at the 47 hospitals participating in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) were utilized. Propensity matching was used within cohorts defined by access site. The impact of bivalirudin use on in-hospital outcomes was evaluated with Fisher's exact tests. Among patients undergoing trans-femoral interventions (TFI), use of bivalirudin was associated with a reduction in bleeding compared with both glycoprotein IIb/IIIa inhibitors (GPI; 1.67 vs. 3.46%, absolute risk reduction (ARR) 1.79%, odds ratio, OR, 0.47, confidence interval, CI, 0.41-0.54, number needed to treat, NNT 56, P < 0.001) and heparin (1.26 vs. 1.76%, ARR 0.5%, OR 0.71, CI 0.61-0.82, NNT 197, P < 0.001). Among patients undergoing TRI, there was a more modest absolute reduction in bleeding with bivalirudin compared with GPI (0.79 vs. 1.41%, ARR 0.62%, OR 0.56, CI 0.34-0.90, NNT 161, P = 0.016) and no difference in bleeding compared with heparin (0.46 vs. 0.46%, OR 1, CI 0.54-1.84, P = 1).

Bivalirudin is markedly efficacious in reducing bleeding in patients undergoing TFI. The reduction in bleeding associated with bivalirudin use is minimal to absent in patients undergoing TRI. Given its lower cost and comparable outcomes, heparin should be the preferred anticoagulation strategy in those undergoing radial PCI.

The growth of the adenocarcinoma cell line derived from human salivary gland (HSG) is regulated by all-trans-retinoic acid (t-RA), which binds to its specific receptor, retinoic acid receptors (RARs), located in the nucleus, and thereby transactivates target genes. In this study, we examined the binding characteristics of the nuclear extract of HSG cells to the retinoic acid response element (RARE) compared with those of in vitro translated RAR alpha and retinoid X receptor alpha (RXR alpha), a heterodimeric partner of RAR alpha. Gel shift analysis using anti-RAR alpha and anti-RXR alpha antibodies revealed that the translated RAR alpha bound to RARE as a heterodimer with RXR alpha. In contrast, the binding of the nuclear extract of HSG cells to RARE showed a heterogeneous pattern, suggesting the existence of several species of RXRs as well as RARs in the nuclei of HSG cells. We therefore tried to clone these putative RXRs by the polymerase chain reaction using degenerated oligonucleotide primers conserved across the RXR family. The DNA sequencing of the recombinant clones revealed the expression of RXR alpha and RXR beta. In addition, chicken ovalbumin upstream promoter-transcription factor I (COUP-TFI), which is also an RXR family member, was cloned. To evaluate the transcriptional activity of RARs and RXRs endogenously expressed in HSG cells, we performed a transient transfection analysis. When HSG cells were transfected with a luciferase reporter plasmid containing two repeats of either the RARE of the RAR beta gene or that of cellular retinol-binding protein II gene, positioned upstream of a thymidine kinase promoter fused to the luciferase sequence, a 2-3-fold induction of luciferase activity was observed in both cases. These results suggest that RARs and RXRs endogenously expressed in HSG cells were transcriptionally active in vivo. Thus, our findings showed that RXR alpha, RXR beta, and COUP-TFI are expressed in HSG cells and suggest that these molecules function as heterodimeric partners of RARs and (or) competitive repressors for RAREs and are involved in cellular responses mediated by retinoids.

Transradial intervention (TRI) approach has emerged as an alternative and competitive method compared with transfemoral intervention (TFI) approach for percutaneous coronary intervention (PCI) in simple to complex coronary disease. TRI, when performed by operators experienced with this technique, appears to have comparable efficacy and procedural resource utilization compared with TFI. However, vascular access complications, specifically major and minor bleeding, can be reduced with TRI. Patients with acute myocardial infarction (AMI) are at the highest risk for periprocedural bleeding for a variety of reasons, and may derive the greatest benefit from TRI. This review article will discuss potential advantages for TRI in the setting of AMI, barriers, and development of a TRI AMI program.

We have developed a PCR-based method to detect, display and directly sequence multiple members of the nuclear hormone receptor (NHR) gene family. Our approach employs the basic concepts of RNA fingerprinting (Welsh et al. (1992) Nucleic Acids Res. 20, 4965-4970; Stone, B. and Wharton, W. (1994) Nucleic Acids Res. 22, 2612-2618) and differential display PCR (Liang, P. and Pardee, A.B. (1992) Science 257, 967-971), with modifications. In contrast to the previous methods, two conserved regions within the gene family were targeted to derive primers for PCR amplification. One of the conserved sites was used to deduce primers for cDNA synthesis. We believe that this strategy led to increased specificity. The use of degenerate primers with low redundancy in both reverse transcription and PCR steps also contributed to enhanced signal-to-noise ratio. The ability to directly sequence the amplified fragments constitutes a vast improvement over the previous methods. This method permitted the successful identification and simultaneous display of six different NHR genes, which included the previously unreported rat homolog of COUP-TFI and a recently described orphan receptor. We believe that this approach provides a convenient and rapid screening method for detecting and characterizing members of a gene family.

This study aimed to determine the effects of Tilburg Frailty Indicator (TFI) and frailty phenotype (FP) in senile inpatients with frailty and provide a reference for the clinical evaluation of debilitating elderly patients. The effect of silver nanoparticle (AgNP)-silver needle acupuncture was also evaluated. Overall, 48 elderly inpatients with an average age of 69.5±6.2 years were included in the study. The results of two weakness assessment methods in screening the same elderly population were compared, and the correlation or consistency between the two methods was analyzed. A AgNPsilver needle was used for acupuncture treatment. The TFI score ranged from 0 to 12, with an average score of 4.0±0.7 (frailty [TFI>5] in 22 elderly patients [45.8%] and non-frailty in 26 patients [54.2%]). FP was presented in different stages, and the FP score ranged from 0 to 5, with an average score of 2.1±1.4, including non-frailty in 12 (25%) patients and pre-frailty in 19 (39.6%) patients. Moreover, 17 patients (35.4%) were debilitated. The two assessment methods showed that the degree of debilitation increased with advancing age in the elderly. The TFI score was positively associated with the defined stage of FP (r = 0.911, P <0.001). The consistency of TFI grading with phenotypic definition kappa value was 0.786 (P <0.001), and the area under the curve was 0.872 (95% confidence interval, 0.834-1.000; P <0.05). After acupuncture and moxibustion, the patient's condition evidently improved. In this study, the proportion of non-debilitating elderly hospitalized patients was higher than that of debilitating elderly hospitalized patients, and the degree of debilitating increased with advancing age. The TFI score was positively associated with the stage of phenotypic definition, and TFI frailty assessment was highly sensitive. Both methods had screening value, but TFI was more effective in screening patients with pre-frailty than FP, resulting in the early intervention and treatment of debilitating elderly hospitalized patients. A silver needle acupuncture can be used for treating senile frailty, providing a new idea for the clinical treatment of frailty.

Faced with health, environmental, and socio-economic issues related to the heavy use of pesticides, diffuse phytosanitary pollution becomes a major concern shared by all the field actors. These actors, namely the farmers and territorial managers, have expressed the need to implement decision support tools for the territorial management of diffuse pollution resulting from the plant protection practices and their impacts. To meet these steadily increasing requests, a cartographic analysis approach was implemented based on GIS which allows the spatialization of the diffuse pollution impacts related to plant protection practices on the Etang de l'Or catchment area in the South of France. Risk mapping represents a support-decision tool that enables the different field actors to identify and locate vulnerable areas, so as to determine action plans and agri-environmental measures depending on the context of the natural environment. This work shows that mapping is helpful for managing risks related to the use of pesticides in agriculture by employing indicators of pressure (TFI) and risk on the applicator's health (IRSA) and on the environment (IRTE). These indicators were designed to assess the impact of plant protection practices at various spatial scales (field, farm, etc.). The cartographic analysis of risks related to plant protection practices shows that diffuse pollution is unequally located in the North (known for its abundant garrigues and vineyards) and in the South of the Etang de l'Or catchment area (the Mauguio-Lunel agricultural plain known for its diversified cropping systems). This spatial inequity is essentially related to land use and agricultural production system. Indeed, the agricultural lands cover about 60% of the total catchment area. Consequently, this cartographic analysis helps the territorial actors with the implementation of strategies for managing risks of diffuse pollution related to pesticides use in agriculture, based on environmental and socio-economic issues and the characteristics of the natural environment.

BACKGROUND

There is no research that evaluates the relationship between the severity of the symptoms of atrial fibrillation (AF), the presence of frailty syndrome and acceptance of the illness.

METHODS

The study included 132 patients aged 72.7 ± 6.73 with diagnosed AF. The severity of the symptoms of AF was determined according to European Heart Rhythm Association (EHRA) guidelines, frailty syndrome was assessed using the Tilburg frailty indicator (TFI) and the acceptance of the illness was assessed using the acceptance of illness scale (AIS). A standard statistical comparison and multiple regression analysis using the stepwise method were performed.

RESULTS

In patients with AF, frailty was 5.31 ± 2.69 (TFI). Frailty syndrome was diagnosed in 59.8% of the AF patients who had a score of 7.17 ± 1.72. A higher level of EHRA score was connected with a smaller degree of the acceptance of the illness p = 0.0000. The multiple regression model indicated that age (p = 0.0009) and the severity of the symptoms (p = 0.0001) are important predictors of frailty syndrome.

CONCLUSIONS

There is a relationship between the presence of frailty syndrome and the intensity of the symptoms and the acceptance of AF. Age and the EHRA score permitted higher levels of frailty syndrome to be predicted.

Introduction: Frailty is a common geriatric syndrome that causes an elevated risk of catastrophic declines in the health and function among older adults - we hypothesized that frailty may be related to the maintenance of sinus rhythm after cardioversion.

Methods: The study sample was a group of 199 consecutive patients over 60 (average age 71.41 ± 6.99; 40.2% women) with AF who were hospitalized in order to perform electrical cardioversion. The Tilburg Frailty Indicator (TFI) was used to assess frailty before cardioversion. The six-month visit after the electrical cardioversion was a follow-up. The follow-up period for the maintenance of sinus rhythm after electrical cardioversion was 180 ± 14 days.

Results: Patients in whom cardioversion was effective had a statistically significantly lower severity of frailty syndrome (3.44 ± 1.83 vs 5.87 ± 1.12; p=0.000) and its components: physical components (2.14 ± 1.33 vs 3.62 ± 1.05 p=0.000); emotional components (0.92 ± 0.79 vs 1.29 ± 0.86 p=0.037) and social components (0.37 ± 0.56 vs 0.96 ± 0.46; p=0.000) compared to those patients in which cardioversion was ineffective. In the logistic regression, frailty (OR: 0.65, 95% CI:0.5010-0.8330; p=0.000) was observed to be an independent predictor for maintaining sinus rhythm.

Conclusion: Frailty is a novel, independent factor that can be used to predict the effectiveness of electrical cardioversion and the maintenance of sinus rhythm in the elderly population. Modifying the level of recognition in the Tilburg Frailty Indicator to a 4 improved the prediction of the effectiveness of electrical cardioversion as well as the maintenance of sinus rhythm.

Keywords: atrial fibrillation; electrical cardioversion; frailty; sinus rhythm.