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Adherence to Physical Activity and Incident Mobility Disability in Older Adults With Mobility Limitations
Get PDFBackground: Preservation of mobility independence is a primary goal in older adults with physical frailty and sarcopenia (PF&S). Interventions based on the combination of physical activity (PA) and nutritional counselling have been indicated as strategies for the management of this condition, although their effectiveness is not confirmed in all investigations. A possible explanation for this uncertain scenario relies in the impact of the adherence to PA interventions. Hence, the present study investigated the impact of the adherence to PA sessions on the incidence of mobility disability in older adults with PF&S. Methods: This is a secondary analysis of an evaluator blinded, randomised controlled trial, developed in 16 clinical sites across 11 European countries, from January 2016 to 31 October 2019. Participants were community-dwelling older adults (70+ years) with PF&S enrolled in the SPRINTT trial (NCT02582138). PF&S was operationalised as having a total score from 3 to 9 on the short physical performance battery (SPPB), low appendicular lean mass and ability to complete the 400-m walk test in < 15 min. Data from participants allocated to a multicomponent intervention (PA with technological support plus nutritional counselling) and a healthy ageing lifestyle education programme (control group) were analysed. Adherence to PA was assessed based on the number of weekly sessions attended. According to recommendations of the American College of Sports Medicine, adherence was categorised as below recommendations (< 2 sessions/week, BR), meeting recommendations (2–3 sessions/week, MR), and above recommendations (> 3 sessions/week, AR). The primary outcome was incident mobility disability, operationalised as incident inability to complete the 400-m walk test in < 15 min during up to 36 months of follow-up. Results: Data of 1444 participants (mean age 79.3 years, 72.6% women) were analysed. In those with SPPB scores of 3–7, MR and AR groups had lower risk of mobility disability compared with controls [MR HR (95% CI): 0.57 (0.41–0.78), p = 0.001; AR HR (95% CI): 0.33 (0.23–0.46), p < 0.001] and BR groups [MR: HR (95% CI): 0.48 (0.34–0.69), p < 0.001; AR: HR (95% CI): 0.27 (0.18–0.38), p < 0.001] in a dose-dependent manner. In those with SPPB scores of 8 or 9, the BR group had a higher risk of mobility disability than controls. MR and AR groups had a lower risk of mobility disability than the BR group. Conclusions: In older adults with PF&S, adherence to PA recommendations is associated with lower incidence of mobility disability. This benefit depends on the degree of adherence as well as baseline physical performance. Trial Registration: ClinicalTrials.gov NCT02582138
Sviluppo e applicazione di un sistema per la calibrazione di sensori di anidride carbonica
No full textQuesto studio presenta la progettazione e la caratterizzazione metrologica di un banco di calibrazione portatile per sensori low‐cost di anidride carbonica (CO2). Il sistema, basato su un’incubatrice ambientale è dotata di controllo di temperatura e umidità relativa e iniezione di gas certificato tramite elettrovalvola, consente profili a concentrazione crescente e set‐point fissi. La ripetibilità della camera è stata valutata prima su dieci cicli di misure per un set-point di 700 ppm e per step crescenti di CO2 da 500 a 2000 ppm, evidenziando un’incertezza complessiva di ± 99 ppm (k = 2). Come caso studio è stato calibrato un sensore low‐cost esponendolo a quattro livelli di concentrazione (600, 1000, 1500, 2000 ppm) e verificandone la ripetibilità a 700 ppm. La regressione lineare ha fornito R2 = 0,99, pendenza 1,2 e bias –154 ppm. Il banco proposto offre un valido compromesso fra costo, portabilità e accuratezza, rendendo praticabili calibrazioni in situ di reti di sensori distribuiti in applicazioni indoor e urban
Interactive wayfinding systems in emergency and evacuation conditions: design of an integrated building component and CAVE-based assessment
No full textEffective Emergency Wayfinding Signages (EWSs) play a critical role in ensuring safe and efficient evacuation during emergencies. This study presents the design and evaluation of an integrated, dynamic EWS within an Immersive Virtual Reality (IVR) environment, leveraging a CAVE-based (Cave Automatic Virtual Environment) experimental setup. The proposed EWS relies on real-time monitoring of environmental emergency conditions, including user behavior analysis, through a centralized data-driven approach. Dynamic signs then show alerts in the evacuation process and address the best evacuation path according to centralized routing algorithms. In particular, the impact of interactive wayfinding technologies on evacuation performance is compared to that of standard passive EWS, considering the effects on user path selection. Results highlight the advantages of dynamic EWS in improving directional guidance under adverse conditions, particularly in scenarios with low visibility due to smoke or power failure. Findings also suggest that IVRbased assessments can serve as a powerful tool for refining emergency signage strategies before real-world implementation, ultimately enhancing occupant safety and evacuation efficienc
Frozen elephant trunk in normothermia without circulatory arrest: initial experience
Get PDFBackground: Aortic arch surgery has evolved significantly with novel techniques aimed at reducing morbidity and mortality. Traditional approaches rely on hypothermic circulatory arrest (HCA), which remains associated with neurological and systemic complications. This study presents our initial experience with a normothermic frozen elephant trunk (FET) technique that eliminates circulatory arrest while maintaining continuous cerebral and systemic perfusion. Methods: A retrospective analysis was conducted on consecutive patients who underwent FET without HCA at Polytechnic University of Marche from September 2019 to January 2025. The surgical strategy included femoral and innominate artery cannulation for extracorporeal circulation, antegrade selective cerebral perfusion (ASCP), and retrograde stent graft deployment with balloon occlusion. Perioperative outcomes, complications, and mid-term follow-up data were evaluated. Results: Twenty-three patients (median age, 73 years) underwent FET without HCA. Indications included degenerative aneurysm (n=14), type I endoleak (n=4), acute aortic dissection (n=2), chronic penetrating ulcer (n=2), and Kommerell's diverticulum (n=1). Technical success was 100%. Two in-hospital deaths occurred due to septic shock and stroke. No cases of permanent spinal cord injury were reported. The median intensive care unit and hospital stays were 4 and 10 days, respectively. The median peak intraoperative lactate level was 1.8 mmol/L (range, 1-4.8 mmol/L). At a median follow-up of 27 months, three patients required distal aortic reintervention due to type Ib (n=2) and type II (n=1) endoleaks. Conclusions: Normothermic FET without circulatory arrest is a feasible and potentially advantageous alternative to traditional techniques, reducing ischemia-reperfusion injury while maintaining cerebral and systemic perfusion. Early outcomes suggest promising results in selected patients, though further studies with larger cohorts are necessary to validate long-term safety and efficacy
How resilient are Mediterranean algal forests? New insights based on the brown alga Gongolaria barbata (Stackhouse) Kuntze
No full textAlthough representing only 0.82% of the world ocean surface, the Mediterranean Sea is a major biodiversity hotspot, hosting about 17,000 marine species among which more than 1,200 macroalgae. Forests formed by brown seaweeds of the genera Cystoseira, Ericaria and Gongolaria (Cystoseira s.l. complex) are a key repository of marine biodiversity in this basin. These communities, widely distributed in the shallow subtidal zone, play many important ecosystem functions. They are, however, impacted by numerous local anthropogenic stressors that have caused their large-scale regression. Additionally, the enclosed nature of the Mediterranean makes them highly vulnerable to climate-related stressors, particularly heat waves. Gongolaria barbata is a canopyforming species of this complex with widespread distribution, but typically occurring in fragmented and geographically isolated populations; as such, it is at risk of local extinction. We are investigating in depth its biology, in order to predict its future responses and plan measures of conservation and restoration. Studies combining microscopic investigations and DNA barcoding and metabarcoding confirm that G. barbata canopies support great biodiversity. Population genetic studies confirm a strong spatial structure and limited connectivity between populations of different regions. Experiments of thermal tolerance showed that recruits of this species are relatively resistant to thermal stress, being able to survive temperatures up to 30°C; however, prolonged periods with temperature above this limit are likely to be lethal. Field-based experiments suggest that recruitment is a critical phase in the development of this species, and is severely affected by high sediment loads and competition with ephemeral algae. Overall, our results suggest that the species is likely to face further future decline and local extinctions, with major losses of associated diversity
Cytogenetic Features and Their Implications in Clinical Practice: A Real-World Analysis of a Large Cohort of Multiple Myeloma Patients
Get PDFUnlabelled: We retrospectively analysed cytogenetics by fluorescence in situ hybridization (FISH) in 1.026 patients with multiple myeloma treated in real-world with the aim to establish its role in daily clinical practice. Thirty-seven percent of patients had no FISH data available. Based on median PFS of each cytogenetic abnormality found, we identified 3 group of patients with a significantly different PFS and determined which patients can best benefit from anti-CD38 regimens and double transplant. These findings support cytogenetic testing in all patients at diagnosis. Background: Cytogenetics by fluorescence in situ hybridization (FISH) plays an increasing prognostic role in multiple myeloma (MM). Methods: we analysed cytogenetics and its implications in 1.026 patients treated in real-world from 2019 to 2023. Low-risk (LR) patients had normal cytogenetic or del(13q); intermediate-risk (IR) had t(11;14), hyperdiploidy, gain(1q) or del(1p); high-risk (HR) group had del(17p)/TP53, amp1q21, t(4;14), t(14:16) or t(14;20). Co-existence of 2 high risk abnormalities was named double hit. Results: FISH data were not evaluable in 383 patients (37%). Out of 643 evaluable patients, chromosome 1 alterations were observed in 119 (18.5%), high risk chromosome 14 translocations in 65 (10%), del(17p)/TP53 in 37 (6%) and double-hit in 7 patients (1%). Cytogenetic was normal or hyperdiploid in 252 (39%) and 59 (13%) patients, respectively. Median PFS of LR, IR and HR group were 57.5, 43.2 and 30.5 months, respectively (P < .001). Although anti-CD38 regimens resulted in significantly longer PFS in both TE and NTE pts, in the former significant benefit was documented in the LR and IR group but not in HR group while in the latter only in the LR group. Tandem transplantation did not improve PFS both overall and in the 3 risk groups. Multivariate Cox regression analysis selected ECOG-PS ≥2, R-ISS II-III and our cytogenetic score HR as factors affecting PFS. Conclusions: in real world, more than one third of MM patients do not have baseline FISH data. Nevertheless, cytogenetics and ECOG PS can be used for prognostic staging and for tailoring therapy
Tunable Optical Properties of Cu/VSe2 from the Visible to Terahertz Spectral Range: A First-Principles Study
Get PDFIn this study, Density Functional Theory (DFT) and Density Functional TightBinding (DFTB) calculations were used to study two different interfaces of Cu/VSe2 as well as four nanodiodes of VSe2 bulk including/excluding the Cu layer. We calculated the electronic and optical properties of two systems of two Cu/VSe2 in which Cu atoms are positioned on the top and at the corner of the VSe2 monolayer lattice. The electronic band structure calculations revealed that the metallic properties of the VSe2 monolayer did not change with the interface of Cu atoms; however, the peak around the Fermi level (EF) in Cu/VSe2(Top) shifted downward to lower energies. The optical properties showed that in the visible range and the wavelengths related to the interband transition/intraband excitation of Cu atoms, the enhancement of Re(ω) values could be observed for both Cu/VSe2(Top) and Cu/VSe2(Corner) nanostructures, while in infrared/terahertz ranges, less/more negative values of Re(ω) were predicted. Through the effect of Cu atoms on the VSe2 monolayer, the intensity of the peaks in the Im(ω) part of the dielectric constant was increased from 0.2 THz for Cu@VSe2(Top) and 2.9 THz for Cu@VSe2(Corner) instead of the zero constant line in the pure system of VSe2. Refractive index (n) calculations indicated the higher indices at 5.4 and 4.6 for Cu/VSe2(Top) and Cu@VSe2(Corner), respectively, in comparison to the value of 2.9 for VSe2. Finally, DFTB calculations predicted higher current values from I(V) characteristic curves of Au/Cu/VSe2/Au and Ag/Cu/VSe2/Ag nanodiodes concerning two other devices without the presence of the Cu layer
Treatment of Osteoporosis and Osteoarthritis in the Oldest Old
Get PDFOsteoporosis and osteoarthritis are key diseases of musculoskeletal ageing and are increasing in prevalence and burden with the progressively ageing population worldwide. These conditions are thus particularly common in ‘the oldest old’, and there are complexities of managing them within the context of extensive multimorbidity, physical and mental disability, and polypharmacy, the rates for all of which are high in this population. In this narrative review, we explore the epidemiology of osteoporosis and osteoarthritis in the oldest old before examining trials and real-world data relating to the pharmacological treatment of these diseases in older adults, including anti-resorptives and bone-forming agents in osteoporosis and symptomatic slow-acting drugs for osteoarthritis, paracetamol, and non-steroidal anti-inflammatory drugs in osteoarthritis, recognising that the oldest old are usually excluded from clinical trials. We then review the potential benefits of nutritional interventions and exercise therapy before highlighting the health economic benefits of interventions for osteoporosis and osteoarthritis. The high prevalence of risk factors for both disease and adverse events associated with treatment in the oldest old mean that careful attention must be paid to the potential benefits of intervention (including fracture risk reduction and improvements in osteoarthritis pain and function) versus the potential harms and adverse effects. Further direct evidence relating to such interventions is urgently needed from future research
Insights into the nanostructuring and phase behaviour of an all-aromatic prototypical nematic liquid crystal
No full textAll-aromatic calamitic liquid crystals are an unconventional family of rigid linear mesogens that represents the closest embodiment of the idealised rod-like molecule central to liquid crystal theories. 2,6-biphenyl naphthalene (PPNPP), a prototypical all-aromatic nematogen, has recently been the focus of scientific interest for both fundamental and technological purposes. While it provides a valuable benchmark for classical theories of nematic order, its experimental study presents challenges given the high temperature of the nematic phase. Herein, molecular dynamics (MD) simulations are contrasted with X-ray diffraction (XRD) data to resolve the thermotropic phase behaviour of PPNPP and the main structural features of its liquid crystal order. The observed trend of the molecular conformation with temperature points to an unexpected and significant distortion of the molecular framework in the nematic phase, which demonstrates the substantial non-linearity of the PPNPP molecule. The simulated mesomorphic behaviour and related thermodynamic parameters are in close agreement with the experimental data. The different phases are described in terms of their molecular organisation, pair distribution function, as well as the orientational and positional order parameters. We compare the classical and extended Maier-Saupe nematic theories with the computationally (MD) and experimentally (XRD) determined orientational order parameters. The observed deviation from the theoretical models indicates substantial inadequacies of the classical theories to describe the nematic-isotropic phase transition for this class of compounds. We suggest that modifications of theory should include the effects of short-range positional order, i.e., cybotaxis