A snapshot of geriatric rehabilitation: one year experience.

OBJECTIVE: Frailty is a common condition in older adults, characterized by multimorbidity, physical weakness and nutritional deficit. Frailty can be detected early and a prehabilitation treatment could reduce the incidence of disability. PATIENTS AND METHODS: Two-hundred-fifteen elderly patients were admitted to the Rehabilitation and Physical Medicine Unit of Policlinico Gemelli for one year. Patients were clinically assessed by Charlson Comorbidity Index (CCI) and blood sample values. Numerical Pain Rating Scale (NRS) and Hand Grip Test were assessed before (T0) and after (T1) hospitalization. Number of drugs and number of infections were recorded. RESULTS: Patients were originally hospitalized in orthopaedic, neurology and medical ward. Most patients (68%) after discharge return home. Negative correlations between albumin and CCI and between total protein and CCI were recorded. Positive correlation between CCI cognitive subscore and number of drugs and a negative correlation between that subscore and Vitamin D were detected. An improvement in NRS and in the handgrip strength was recorded. At discharge an increase in the number of drugs and the number of infections was noted. CONCLUSIONS: The handgrip strength improvement increases quality of life. Pain management and NRS indicate a better recovery of activities of daily living. Malnutrition is a real problem; albumin is the principal negative acute-phase reactant and is related to a worse clinical condition and low vitamin D levels are associated with worse cognitive function. The goal of a Rehabilitation Unit is to create an effective multidisciplinary transitional care plan, involving the patient and caregivers, creating a continuity of care after discharge and a sustainable project.

Prehabilitation and heart failure: perspective in primary outcomes, a randomized controlled trial.

OBJECTIVE: Prehabilitation, intended as a multidisciplinary approach where physical training is combined with educational and counselling training, in cardiology could optimizing care, and has been shown to be able to reduce morbidity and mortality in several diseases. The present study aims to assess the effectiveness of a prehabilitation program in elderly patients (over 65) with chronic heart failure and to evaluate functional and quality indices of life. PATIENTS AND METHODS: This is randomized, single blind controlled trial. Fourteen older adult patients diagnosed with chronic heart failure were enrolled. Patients were randomly assigned into the study or the control group. Patients in the study group underwent physical training organized into 10 twice-weekly meetings, nutritional and lifestyle counseling. RESULTS: In the Study Group, the quality of life improved significantly (EQoL-5D), and between the two groups there is a statistically significant difference in the motor dimension of SF-36. CONCLUSIONS: Because of our preliminary results, prehabilitation program should be included among the management strategies of in elderly patients with chronic heart failure to better manage their disease and to improve their Quality of Life.

Confined direct and reverse chemical gardens: Influence of local flow velocity on precipitation patterns.

Various cobalt silicate precipitation patterns can be observed when an aqueous solution of cobalt ions gets into contact with a solution of silicate ions upon injection of one solution into the other in the confined geometry of a Hele-Shaw cell. The properties of these precipitation patterns are studied here as a function of the injection flow rate, densities and viscosities of the solutions, and the choice of which solution is injected into the other one. Our results show that the structure of the precipitation pattern depends on the local velocity as well as on the difference in viscosities between the injected and the displaced solutions. Specifically, decreasing the injection flow rate and/or decreasing the density jump while increasing the difference in viscosities between the reactant solutions results in more circular patterns. Moreover, we show that some structures are robustly observed in given ranges of the local flow velocity in the cell. Locally, precipitation can then transition from one type of pattern to another during injection, according to that preferred structure at the given local velocity. We also show that injection of the cobalt solution into the silicate solution results in the so-called direct patterns that are different from the reverse patterns obtained when the silicate solution is injected in the solution of cobalt ions. Our results help in understanding the production of precipitate structures under nonequilibrium flow conditions.

Robust estimation of the motile cilia beating frequency.

The estimation of the cilia beating frequency (CBF) is of great interest in understanding how the CBF modulates liquid fluxes and how it is controlled by the ciliated cell intra- and/or extracellular medium composition in physiological processes. Motion artifacts and camera defaults may hinder the computation of the frequency variations during long-lasting experiments. We have developed a new analysis approach consisting of a preliminary corrective step (removal of a grid pattern on the image sequence and shift compensation), followed by a harmonic model of the observed cilia using a maximum likelihood estimator framework. It is shown that a more accurate estimation of the frequency can be obtained by averaging the squared Fourier transform of individual pixels followed by a particular summation over the different frequencies, namely the compressed spectrum. Robustness of the proposed method over traditional approaches is shown by several examples and simulations. The method is then applied to images of samples containing ciliated ependymal cells located in the third cerebral ventricle of mouse brains, showing that even small variations in CBF in response to changes in the amount of oxygenation, pH or glucose were clearly visible in the computed frequencies. As a conclusion, this method reveals a fine metabolic tuning of the cilia beating in ependimocytes lining the third cerebral ventricle. Such regulations are likely to participate in homeostatic mechanisms regulating CSF movements and brain energy supply.

Silo collapse under granular discharge.

We investigate, at a laboratory scale, the collapse of cylindrical shells of radius R and thickness t induced by a granular discharge. We measure the critical filling height for which the structure fails upon discharge. We observe that the silos sustain filling heights significantly above an estimation obtained by coupling standard shell-buckling and granular stress distribution theories. Two effects contribute to stabilize the structure: (i) below the critical filling height, a dynamical stabilization due to granular wall friction prevents the localized shell-buckling modes to grow irreversibly; (ii) above the critical filling height, collapse occurs before the downward sliding motion of the whole granular column sets in, such that only a partial friction mobilization is at play. However, we notice also that the critical filling height is reduced as the grain size d increases. The importance of grain size contribution is controlled by the ratio d/√[Rt]. We rationalize these antagonist effects with a novel fluid-structure theory both accounting for the actual status of granular friction at the wall and the inherent shell imperfections mediated by the grains. This theory yields new scaling predictions which are compared with the experimental results.

Neuroprotective and neuroproliferative activities of NeuroAid (MLC601, MLC901), a Chinese medicine, in vitro and in vivo.

Although stroke remains a leading cause of death and adult disability, numerous recent failures in clinical stroke trials have led to some pessimism in the field. Interestingly, NeuroAid (MLC601), a traditional medicine, particularly used in China, South East Asia and Middle East has been reported to have beneficial effects in patients, particularly in post-stroke complications. Here, we demonstrate in a rodent model of focal ischemia that NeuroAid II (MLC901) pre- and post-treatments up to 3 h after stroke improve survival, protect the brain from the ischemic injury and drastically decrease functional deficits. MLC601 and MLC901 also prevent neuronal death in an in vitro model of excitotoxicity using primary cultures of cortical neurons exposed to glutamate. In addition, MLC601/MLC901 treatments were shown to induce neurogenesis in rodent and human cells, promote cell proliferation as well as neurite outgrowth and stimulate the development of a dense axonal and dendritic network. MLC601 and MLC901 clearly represent a very interesting strategy for stroke treatment at different stages of the disease.

Barrier-wave-internal-wave interference and airy minima in 16O16+O elastic scattering

Taking 16O+16O elastic scattering at 124 MeV as an example, we show that a barrier-wave-internal-wave decomposition of the elastic scattering amplitude provides valuable information on the light heavy-ion interaction and complements the more conventional nearside-farside decomposition. In particular, we show that the Airy minima present in the angular distributions are due to a barrier-wave-internal-wave interference mechanism, which sheds additional light on the exceptional transparency displayed by some light heavy-ion scattering systems. Extension of these ideas to other fields, like atomic and molecular collision physics, could prove rewarding.

Firefly luciferase generates two low-molecular-weight light-emitting species.

A bioluminescent D-luciferin-luciferase mixture is separated by gel filtration during the time course of the reaction. A simultaneous analysis with an UV-visible diode array detector and an on-line luminometer gives nonsuperimposable chromatograms. Luminescence recordings display three peaks, one associated with the enzyme (light-emitting species 1: LES(1)), and two other species free from the luciferase: LES(2), with a luciferyl-adenylate-like spectrum and LES(3). Production of these two species is nucleotide (ATP or 2'-dATP)- and pH-dependent. The chromatographic data presented here could lead to reconsideration of the generally assumed emission mechanism, which involves one emitter only. It could also suggest that each free emitting species is related to a colour of emission corresponding to the two defined wavelengths previously described ( approximately 575 and approximately 620 nm).