Implementing Occupational Therapy into an Acute Geriatric Ward: Effects on Patients' Functional Status at Discharge.

Older patients face increasing challenges in preserving mobility during hospitalization. This retrospective cohort study aimed to evaluate the effect of an Occupational Therapy (OT) program on mobility at discharge in older patients admitted to an Acute Geriatric Unit (AGU). All patients aged ≥65 years consecutively admitted to the AGU in an 18-month period were included in the study if scoring <4 or ≥ 8 at the Clinical Frailty Scale. Overall, 807 patients (median age 85 years, 50.2% females) were included: 665 (82%) received OT, while 142 who did not receive OT were used as controls. The Cumulated Ambulation Scale (CAS) was used to assess mobility at discharge. By multivariable logistic regression, OT was independently associated with higher odds of achieving higher CAS score at discharge. These findings emphasize the potential benefits of OT in acute geriatric settings, providing valuable insights for preserving mobility of frail older individuals during hospitalization.

Dissection of functional NF-Y-RFX cooperative interactions on the MHC class II Ea promoter.

Transcription of major histocompatibility complex (MHC) class II genes depends upon the trimeric complexes RFX and NF-Y binding to the conserved X-Y promoter elements. We produced and purified the RFX subunits from Escherichia coli, reconstituted DNA-binding to the mouse Ea X box and dissected the interactions with NF-Y. RFX and NF-Y do not interact in solution, but make cooperative interactions in EMSA: a minimal NF-Y, composed of the evolutionary conserved domains, is sufficient and the RFXAP N-terminal half is expendable. Altering the X-Y distance abolishes cooperativity, indicating that DNA imposes severe spatial constraints. When tested on a highly positioned nucleosome, RFX binds DNA well and NF-Y does not increase its affinity further. Transfections of NF-Y subunits, but not RFX, in class II negative cells improves basal transcription and coexpression of the two activators has a synergistic effect, while modestly increasing CIITA-mediated activation. These results show that interactions between the two trimers on DNA are key to MHC class II expression.