Seedless Cu Electroplating on Ru-W Thin Films for Metallisation of Advanced Interconnects.

For decades, Ta/TaN has been the industry standard for a diffusion barrier against Cu in interconnect metallisation. The continuous miniaturisation of transistors and interconnects into the nanoscale are pushing conventional materials to their physical limits and creating the need to replace them. Binary metallic systems, such as Ru-W, have attracted considerable attention as possible replacements due to a combination of electrical and diffusion barrier properties and the capability of direct Cu electroplating. The process of Cu electrodeposition on Ru-W is of fundamental importance in order to create thin, continuous, and adherent films for advanced interconnect metallisation. This work investigates the effects of the current density and application method on the electro-crystallisation behaviour of Cu. The film structure, morphology, and chemical composition were assessed by digital microscopy, atomic force microscopy, scanning and transmission electron microscopies, energy-dispersive X-ray spectroscopy, and X-ray diffraction. The results show that it was possible to form a thin Cu film on Ru-W with interfacial continuity for current densities higher than 5 mA·cm-2; however, the substrate regions around large Cu particles remained uncovered. Pulse-reverse current application appears to be more beneficial than direct current as it decreased the average Cu particle size.

Does Interrupting Prolonged Sitting With 10- or 20-Min Standing Attenuate Postprandial Glycemia and Blood Pressure in Middle-Aged and Older Adults With Type 2 Diabetes?

We carried out three types of 2-hr experimental sessions with middle-aged and older adults with Type 2 diabetes in order to examine the acute effect of interrupting prolonged sitting with varying periods of standing on postprandial glycemia and blood pressure (BP): (a) prolonged sitting after breakfast; (b) standing for 10 min, 30 min after breakfast; and (c) standing for 20 min, 30 min after breakfast. Glucose and BP were assessed before and after breakfast. A generalized linear model revealed no significant differences for the incremental area under the curve of glucose between standing for 10 min, 30 min after breakfast, versus prolonged sitting after breakfast (ß = -4.5 mg/dl/2 hr, 95% CI [-17.3, 8.4]) and standing for 20 min, 30 min after breakfast, versus prolonged sitting after breakfast (ß = 0.9 mg/dl/2 hr, 95% CI [-11.9, 13.7]). There was no difference in area under the curve of systolic and diastolic BP among the sessions. Interrupting prolonged sitting time with 10 or 20 min of standing 30 min after breakfast does not attenuate postprandial glycemia or BP in middle-aged and older adults with Type 2 diabetes.

Dietary availability in elderly Portuguese households.

OBJECTIVE: To identify dietary availability and its time trends in elderly Portuguese households. DESIGN: A set of four cross-sectional studies based on the Household Budget Surveys was used. The dietary data were described using the daily per capita availability of food and beverages, energy and selected nutrients (macronutrients, different lipid fractions and simple sugars). Differences between elderly household types and time trends were studied. SETTING: Portuguese Household Budget Survey data from 1989/1990, 1994/1995, 2000/2001 and 2005/2006. SUBJECTS: Households with members aged ≥65 years were selected and categorized as solitary elderly female, solitary elderly male or couple (composed of one elderly female and one elderly male). RESULTS: While cereals, fats/oils, potatoes and sugar/sugar products decreased, an increase occurred in milk/milk products, fruits, bottled water, fruit/vegetable juices and soft drinks (P<0·05). The highest values for foods and beverages were mostly found in couples, while the lowest ones were from solitary males. Exceptions were observed for cereals, eggs, milk/milk products, vegetables, fruits and non-alcoholic beverages, higher in solitary females; and for sugar/sugar products and alcoholic beverages, higher in solitary males. Over time, total energy and carbohydrates decreased while proteins and saturated fatty acids increased (P<0·001). Lipids increased in solitary males and couples (P<0·05). Simple sugars increased in solitary males but decreased in solitary females and couples (P<0·05). CONCLUSIONS: The increases in fruits and vegetables in solitary females accord with a healthier food pattern, but overall imbalances in the macronutrient profile for all elderly households may imply a decreasing diet quality.

Eating behaviour among undergraduate students. Comparing nutrition students with other courses.

Our main aim was to compare eating behaviour between Portuguese undergraduate nutrition students and students attending other courses. Several eating behaviour dimensions were compared between 154 nutrition students and 263 students from other areas. Emotional and external eating were assessed by the Dutch Eating Behavior Questionnaire, dietary restraint was measured using the flexible and rigid control of eating behaviour subscales, binge eating was measured using the Binge Eating Scale, and eating self-efficacy using the General Eating Self-Efficacy Scale. Higher levels of flexible and rigid control were found in nutrition students from both sexes when compared to students from other courses. Female nutrition students also presented higher binge eating levels than their colleagues from other courses. To our knowledge no other work has previously assessed all eating behaviour dimensions considered in the current study among nutrition students. Besides the results by themselves, the data obtained from this study provide several clues to further studies to be developed regarding the still rarely approached issue of eating behaviour among nutrition students.

Assessment of Intuitive Eating and Mindful Eating among Higher Education Students: A Systematic Review.

BACKGROUND: The role of mindful eating (ME) and intuitive eating (IE) in improving eating behavior, diet quality, and health is an area of increasing interest. OBJECTIVE: The objective of this review was to identify the instruments used to assess ME and IE among higher education students and outcomes related to these dimensions. METHODS: This review was carried out according to the PRISMA statement, through systematic searches in PubMed, Web of Science, PsycInfo, and Scopus. The inclusion criteria selected for higher education students, levels of ME and/or IE reported, and observational and clinical studies. The exclusion criteria selected against reviews, qualitative studies, and case studies. Quality was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist. RESULTS: A total of 516 initial records were identified, from which 75 were included. Cross-sectional studies were the most common research design (86.7%). Most studies were conducted with samples that were predominantly female (90.7%), White (76.0%), aged 18 to 22 years (88.4%), with BMI < 25 kg/m2 (83.0%), and in the United States (61.3%). The Intuitive Eating Scale (IES), the Mindful Eating Questionnaire (MEQ), and their different versions were the most used instruments. The outcomes most studies included were eating behavior and disorders (77.3%), anthropometric assessments (47.8%), mental health (42.0%), and body image (40.6%). Regarding the quality of studies, 34.7% of studies were assigned a positive, 1.3% a negative, and 64.0% a neutral rate. CONCLUSIONS: IES and MEQ were the most used instruments. RCT and cohort studies are scarce, and future research with a higher level of quality is needed, especially on the topics of food consumption, diet quality, and biochemical markers.

Risk of Eating Disorders and Social Desirability among Higher Education Students: Comparison of Nutrition Students with Other Courses.

The transition to college is a period of higher risk of the development of eating disorders, with nutrition/dietetics students representing a group of particular vulnerability. Hence, it is interesting to assess eating disorders, taking into consideration potential sources of bias, including social desirability. Our aims were to compare the risk of eating disorders between students of nutrition/dietetics and those attending other courses and to study potential social desirability biases. A total of 799 higher education students (81.7% females) aged 18 to 27 years old completed a questionnaire assessing the risk of eating disorders (EAT-26) and social desirability (composite version of the Marlowe-Crowne Social Desirability Scale). The proportion of students with a high risk of eating disorders was higher among females (14.5% vs. 8.2%, p = 0.044). Nutrition/dietetics students did not differ from those attending other courses regarding the risk of eating disorders. The social desirability bias when assessing the risk of eating disorders was overall low (EAT-26 total score: r = -0.080, p = 0.024). Social desirability correlated negatively with the Diet (r = -0.129, p < 0.001) and Bulimia and food preoccupation subscales (r = -0.180, p < 0.001) and positively with Oral self-control (r = 0.139, p < 0.001).

Eight Weeks of Intermittent Exercise in Hypoxia, with or without a Low-Carbohydrate Diet, Improves Bone Mass and Functional and Physiological Capacity in Older Adults with Type 2 Diabetes.

In an increasingly aging and overweight population, osteoporosis and type 2 diabetes (T2DM) are major public health concerns. T2DM patients experience prejudicial effects on their bone health, affecting their physical capacity. Exercise in hypoxia (EH) and a low-carbohydrate diet (LCD) have been suggested for therapeutic benefits in T2DM, improving bone mineral content (BMC) and glycemic control. This study investigated the effects of EH combined with an LCD on body composition and functional and physiologic capacity in T2DM patients. Older T2DM patients (n = 42) were randomly assigned to the following groups: (1) control group: control diet + exercise in normoxia; (2) EH group: control diet + EH; (3) intervention group: LCD + EH. Cardiopulmonary tests (BRUCE protocol), body composition (DEXA), and functional capacity (6MWT, handgrip strength) were evaluated. Body mass index (kg/m2) and body fat (%) decreased in all groups (p < 0.001). BMC (kg) increased in all groups (p < 0.001) and was significantly higher in the EH and EH + LCD groups (p < 0.001). VO2peak improved in all groups (p < 0.001), but more so in the hypoxia groups (p = 0.019). Functional capacity was increased in all groups (p < 0.001), but more so in the EH group in 6MWT (p = 0.030). EH with and without an LCD is a therapeutic strategy for improving bone mass in T2DM, which is associated with cardiorespiratory and functional improvements.

Eating behaviour patterns and BMI in Portuguese higher education students.

Our aim was to determine prototypical patterns of eating behaviour among Portuguese higher education students, and to relate these patterns with BMI. Data from 280 higher education students (63.2% females) aged between 18 and 27 years were analysed. Several eating behaviour dimensions (emotional and external eating, flexible and rigid restraint, binge eating, and eating self-efficacy) were assessed, and eating styles were derived through cluster analysis. BMI for current, desired and maximum self-reported weights and the differences between desired and current BMI and between maximum and current BMI were calculated. Women scored higher in emotional eating and restraint, whereas men showed higher eating self-efficacy. Men had higher current, desired and maximum BMI. Cluster analysis showed three eating styles in both male and female subsamples: "Overeating", "High self-efficacy" and "High restraint". High self-efficacy women showed lower BMI values than the others, and restrictive women had higher lost BMI. High self-efficacy men showed lower desired BMI than overeaters, and lower maximum and lost BMI than highly restrictive ones. Restrictive women and men differ on important eating behaviour features, which may be the cause of differences in the associations with BMI. Eating self-efficacy seems to be a central variable influencing the relationships between other eating behaviour dimensions and BMI.

Patterns of Eating Behavior among 13-Year-Old Adolescents and Associated Factors: Findings from the Generation XXI Birth Cohort.

Eating behavior adopted during adolescence may persist into adulthood. The aims of this study were to identify eating behavior patterns among Portuguese adolescents and to explore whether groups differ in terms of early life and family characteristics, severity of depressive symptoms, and body mass index (BMI) z-score. Participants were 3601 13-year-olds enrolled in the birth cohort Generation XXI. Eating behavior was assessed using the self-reported Adult Eating Behavior Questionnaire (AEBQ), validated in this sample. The severity of depressive symptoms was measured through the Beck Depression Inventory (BDI-II), and data on sociodemographic and anthropometrics were collected at birth and 13-years-old. Latent class analysis was conducted, and associations were estimated using multinomial logistic regression models. Five patterns of individuals were identified: "Picky eating", "Disinterest towards food", "Food neophilia", "Emotional eating", and "Food attractiveness". The adolescents' sex, maternal education, BMI z-score, and severity of depressive symptoms were significantly associated with the identified patterns. In particular, adolescents with a higher BMI z-score were more likely in "Food neophilia" while individuals with more severe depressive symptoms were in the "Picky eating", "Emotional eating", and "Food attractiveness" patterns. These findings suggest a starting point for the development and planning of targeted public health interventions.

Nutritional Status among Portuguese and Turkish Older Adults Living in the Community: Relationships with Sociodemographic, Health and Anthropometric Characteristics.

Malnutrition is widespread among older adults, and its determinants may differ between countries. We compared Portuguese and Turkish non-institutionalized older adults regarding nutritional status, sociodemographic, health and anthropometric characteristics and studied the relationships between nutritional status and those characteristics. This cross-sectional study analyzed data from 430 Portuguese and 162 Turkish non-institutionalized older adults regarding sociodemographics, health conditions, the Mini-Nutritional Assessment (MNA-FF) and anthropometry. Turkish older adults were more likely to be malnourished or at risk of malnutrition and had lower average BMI but a higher calf circumference. A higher proportion of the Portuguese sample had tooth loss, diabetes, hypertension, oncologic diseases, kidney diseases, osteoarticular problems or eye problems, while less had anemia. A better nutritional status (higher MNA-FF score) was found among the Portuguese, males, people using dentures, those without tooth loss, hypertension, cardiovascular diseases, anemia or oncological diseases and was related to younger age, higher BMI and a higher calf circumference. Malnutrition and its risk were higher among older adults from Turkey, despite Portuguese older adults presenting a higher prevalence of chronic diseases. Being female, older age, tooth loss, hypertension, anemia, CVD or oncological disorders and having a lower BMI or CC were associated with higher rates of malnutrition among older adults from Portugal and Turkey.

Transgenic expression of Laminin α1 chain does not prevent muscle disease in the mdx mouse model for Duchenne muscular dystrophy.

Duchenne muscular dystrophy (DMD) is a severe neuromuscular disorder, and one of the most frequently encountered, but one for which there is as yet no treatment. Laminin-111 protein therapy was recently shown to be a promising approach to prevent muscle disease in the mdx mouse model of DMD. The present study demonstrated that transgenic expression of laminin α1 chain in mdx animals, resulting in laminin-111 heterotrimer formation in mdx muscle, does not improve the dystrophic phenotype. The mdx mice overexpressing laminin-111 (mdxLMα1) display features of mdx littermates: dystrophic pattern of muscle biopsy, elevated creatine kinase levels, reduced muscle strength, and decreased sarcolemmal integrity. Increased expression of integrin α7 is not beneficial for mdxLMα1 muscle, and components of the dystrophin-glycoprotein complex are not restored at the sarcolemma on laminin-111 overexpression. In summary, further studies are needed to verify the functionality of laminin-111 protein therapy in DMD and to describe the molecular events resulting from this approach.

Co-W Barrier Layers for Metallization of Copper Interconnects: Thermal Performance Analysis.

The back-end-of-line (BEOL) copper interconnect structure has been subjected to downscaling for the last two decades, while the materials used for conforming and assuring its physical integrity during processing have faced significant obstacles as the single-digit nanometer process node is implemented. In particular, the diffusion barrier layer system comprised of Ta/TaN has faced major constraints when it comes to the electrical performance of the smaller Cu lines, and thus alternative formulations have been investigated in recent years, such as Ru-Ta or Co-W alloys. In this work, we assess how PVD (physical vapor deposition) deposited equimolar Co-W films perform when exposed to different vacuum annealing temperatures and how these films compare with the Ta adhesion layer used for Cu seeding in terms of dewetting resistance. The stacks were characterized using scanning electron microscopy (SEM), X-ray diffraction (XRD), transmission electron microscopy (TEM) and scanning transmission electron microscopy (STEM) coupled with energy dispersive X-ray spectroscopy (EDX) mapping. The Cu film at the surface of the Cu/Co-W system exhibited grain growth starting at 300 °C, with the formation of abnormally large Cu grains starting at 450 °C. Sheet resistance reached a minimum value of 7.07 × 10-6 Ω/sq for the Cu/Co-W stack and 6.03 × 10-6 Ω/sq for the Cu/Ta stack, both for the samples annealed at 450 °C.

The Effect of Ultrasonic Agitation on the Seedless Growth of Cu on Ru-W Thin Films.

Ru attracted considerable attention as a candidate to replace TaN as a diffusion barrier layer for Cu interconnect metallisation. The addition of W improves the diffusion barrier properties of Ru but appears to weaken the adhesion strength between the barrier and Cu and the direct (seedless) electroplatability behaviour. Although Cu can be directly electroplated on near equimolar Ru-W thin films, no complete substrate coverage is obtained. The understanding of Cu electrocrystallisation on Ru−W is essential to develop methods of fabricating thin, continuous, and well adherent films for advanced interconnect metallisation, where Ru−W thin films could be used as diffusion barriers. This work studies the effect of ultrasonic agitation on the growth of Cu films electroplated on Ru−W, namely on the impact on substrate coverage. Film structure, morphology and chemical composition were evaluated by digital and scanning and transmission electron microscopies, and X-ray diffraction. The results show that Cu particles decrease with increasing current density, but when no electrolyte agitation is applied, substrate coverage is incomplete in the central region, with openings around larger Cu particles, regardless of current density. Under ultrasonic agitation, substrate coverage is remarkably improved. An active particle detachment mechanism is proposed as responsible for attaining improved substrate coverage, only possible at intermediate current density. Lower current densities promote growth over nucleation, whereas higher currents result in extensive hydrogen reduction/formation. Ultrasonic agitation also enhances a preferential Cu growth along <111> direction.

Metabolic syndrome, adipokines and ghrelin in overweight and obese schoolchildren: results of a 1-year lifestyle intervention programme.

The aim of this study was to evaluate the effect of a lifestyle intervention programme (nutrition and exercise counselling) on metabolic syndrome (MS) components, adipokines (leptin, adiponectin) and ghrelin levels in overweight children. A total of 61 overweight children aged 7-9 years (≥ 85th body mass index (BMI) percentile; 27 boys/34 girls) were randomly assigned and completed a 1-year individual (IT) or group-based treatment (GT). Anthropometric and biochemical parameters were assessed at baseline, at 6 months and at 1 year. Twenty-two normal weight children (<85th BMI percentile; 7-9 years old; 13 boys/nine girls) were also evaluated at baseline. Insulin resistance (IR) was determined by the homeostasis model assessment of IR (HOMA-IR). Overweight children presented significantly higher blood pressure, triglycerides, apolipoprotein B, insulin, HOMA-IR, leptin, C-reactive protein and homocysteine levels, while apolipoprotein A-I was significantly lower. At baseline, MS was present in ten overweight children, of which only five maintained it at 1 year. Leptin and ghrelin levels were associated with IR and MS components. MS was predicted by apolipoprotein A-I, insulin and pre-puberty. The lifestyle intervention led to a significant improvement in standard deviation score of BMI, waist circumference/height ratio and lipid profile. Changes in insulin, HOMA-IR, leptin and adiponectin were not significant. Ghrelin behaved differently between IT and GT. The GT intervention seems to be more successful, with a decrease in BMI Z-score and an improvement of metabolic parameters. In conclusion, overweight children have multiple risk factors associated with MS. A lifestyle intervention programme seems to be an effective mean for reducing obesity and MS components and improving adipokines concentrations.

Prevalence of overweight and obesity among 7-9-year-old children in Aveiro, Portugal: comparison between IOTF and CDC references.

OBJECTIVE: To estimate the prevalence of overweight and obesity in schoolchildren from Aveiro, Portugal, according to two criteria: the International Obesity Task Force (IOTF) and the US Centers for Disease Control and Prevention (CDC) cut-offs. DESIGN: Weight, height and waist circumference were measured. Using the BMI, gender- and age-specific prevalences of overweight and obesity were determined according to the IOTF cut-offs extrapolated from an adult BMI of 25 and 30 kg/m2 and the CDC cut-off values of 85th and 95th BMI percentile. SETTING: Aveiro, Portugal. SUBJECTS: A random representative sample of 905 children (457 boys; 448 girls) aged 7-9 years. RESULTS: The prevalence of excess weight (overweight and obesity) was lowest according to IOTF cut-offs compared to CDC (28.1 % v. 31.2 %), especially obesity (8.1 % v. 14.0 %). However, the CDC and IOTF criteria have a strong agreement (Cohen's k = 0.755; P < 0.001). There were significant differences in excess weight between boys and girls according to the CDC (26.9 % v. 35.7 %; P = 0.003). Obese children are younger and the majority present abdominal obesity. CONCLUSIONS: The present study shows a high prevalence of excess weight in Aveiro children, similar to other Portuguese regions and among the highest in Europe, especially in the female gender. The IOTF cut-off values give a lower prevalence of excess weight, namely obesity.

An extended version of the MNA-SF increases sensitivity in identifying malnutrition among community living older adults. Results from the PRONUTRISENIOR project.

BACKGROUND & AIMS: The Mini Nutritional Assessment (MNA) is the most used tool to assess malnutrition and/or its risk among older adults. Its Screening section was proposed as a short form (MNA-SF) but studies comparing the two forms present controversial results. Our main aims were to study the agreement between MNA-SF and its full form (MNA-FF) among Portuguese older adults living in the community and to develop a more sensible version of the MNA-SF. MATERIAL AND METHODS: This cross-sectional study used a convenience sample of 456 older adults (54.2% females) aged 65-92 years (mean = 73; SD = 6). Data analyzed included: nutritional status (MNA), social support (Fillenbaum's Social Network Index), level of independency in daily activities (Lawton e Brody's scale) and eating-related quality of life. Both MNA-FF and MNA-SF classify participants as malnourished, at risk of malnutrition or with normal nutrition status. Anthropometric assessments (weight, height, arm and calf perimeters) were carried out and BMI was computed. RESULTS: The agreement between the two classifications is 82.7%, but Cohen's k shows a weak agreement (weighted Cohen's k = 0.497; p < 0,001), and the sensitivity of the MNA-SF to detect malnutrition or its risk (as assessed by the MNA-FF) was 42.6% (despite a specificity of 98.8%). Participants classified as normal using the MNA-SF despite at risk using the MNA-FF present lower scores in two items from the Assessment section (number of full meals eaten daily and amount of fluid consumed per day). These were included in MNA-SF to obtain an extended short-version (MNA-SF8). The difference between the ROC curves for MNA-SF and MNA-SF8 justifies the preferential use of the MNA-SF8 with an estimated cut-off of 14 points, which showed high sensitivity (91.8%) and specificity (79.9%). CONCLUSIONS: The addition of two items to the MNA-SF provides a more sensible tool to detect the risk of malnutrition among older adults. General eating-related questions seem relevant to assess malnutrition in this age group.

Seedless Cu Electroplating on Co-W Thin Films in Low pH Electrolyte: Early Stages of Formation.

The use of Ta/TaN barrier bilayer systems in electronic applications has been ubiquitous over the last decade. Alternative materials such as Co-W or Ru-W alloys have gathered interest as possible replacements due to their conjugation of favourable electrical properties and barrier layer efficiency at reduced thicknesses while enabling seedless Cu electroplating. The microstructure, morphology, and electrical properties of Cu films directly electrodeposited onto Co-W or Ru-W are important to assess, concomitant with their ability to withstand the electroplating baths/conditions. This work investigates the effects of the current application method and pH value of the electroplating solution on the electrocrystallisation behaviour of Cu deposited onto a Co-W barrier layer. The film structure, morphology, and chemical composition were studied by X-ray diffraction, scanning electron microscopy and atomic force microscopy, as well as photoelectron spectroscopy. The results show that the electrolyte solution at pH 1.8 is incapable of creating a compact Cu film over the Co-W layer in either pulsed or direct-current modes. At higher pH, a continuous film is formed. A mechanism is proposed for the nucleation and growth of Cu on Co-W, where a balance between Cu nucleation, growth, and preferential Co dissolution dictates the substrate area coverage and compactness of the electrodeposited films.

Sex and age differences in attitudes and intention to adopt personalised nutrition in a UK sample.

AIM: There has been an increase in the development of technologies that can deliver personalised dietary advice. Devising healthy, sustainable dietary plans will mean taking into consideration extrinsic factors such as individual social circumstances. The aim of this study was to identify societal groups more or less receptive to and likely to engage with personalised nutrition initiatives. SAMPLE AND METHODS: Volunteers were recruited via a social research agency from within the UK. The resultant sample (N = 1061) was 49% female, aged 18-65 years. RESULTS: MANOVA (Tukey HSD applied) indicated that females and younger people (aged 18-29 years) had more favourable attitudes and were more likely to intend to adopt personalised nutrition. There were no differences in attitude toward or intention to adopt personalised nutrition between different education levels, income brackets or occupational groups. CONCLUSION: These results imply that females and younger people may be most likely to adopt personalised nutrition in the future. Initiatives to promote healthy eating should target males and older people.

High prevalence of malnutrition in Internal Medicine wards - a multicentre ANUMEDI study.

BACKGROUND: Disease-related malnutrition is a significant problem in hospitalized patients, with high prevalence rates depending on the studied population. Internal Medicine wards are the backbone of the hospital setting. However, prevalence and determinants of malnutrition in these patients remain unclear. We aimed to determine the prevalence of malnutrition in Internal Medicine wards and to identify and characterize malnourished patients. METHODS: A cross-sectional observational multicentre study was performed in Internal Medicine wards of 24 Portuguese hospitals during 2017. Demographics, hospital admissions during the previous year, type of admission, primary diagnosis, Charlson comorbidity index, and education level were registered. Malnutrition at admission was assessed using Patient-Generated Subjective Global Assessment (PG-SGA). Demographic characteristics were compared between well-nourished and malnourished patients. Logistic regression analysis was used to identify determinants of malnutrition. RESULTS: 729 participants were included (mean age 74 years, 51% male). Main reason for admission was respiratory disease (32%). Mean Charlson comorbidity index was 5.8 ±â€¯2.8. Prevalence of malnutrition was 73% (56% moderate/suspected malnutrition and 17% severe malnutrition), and 54% had a critical need for multidisciplinary intervention (PG-SGA score ≥9). No education (odds ratio [OR] 1.88, 95% confidence interval [CI]: 1.16-3.04), hospital admissions during previous year (OR 1.53, 95%CI: 1.05-2.26), and multiple comorbidities (OR 1.22, 95%CI: 1.14-1.32) significantly increased the odds of being malnourished. CONCLUSIONS: Prevalence of malnutrition in the Internal Medicine population is very high, with the majority of patients having critical need for multidisciplinary intervention. Low education level, admissions during previous year, and multiple comorbidities increase the odds of being malnourished.

Early skeletal muscle pathology and disease progress in the dy3K/dy3K mouse model of congenital muscular dystrophy with laminin α2 chain-deficiency.

Deficiency of laminin α2 chain leads to a severe form of congenital muscular dystrophy (LAMA2-CMD), and dystrophic symptoms progress rapidly in early childhood. Currently, there is no treatment for this detrimental disorder. Development of therapies is largely hindered by lack of understanding of mechanisms involved in the disease initiation and progress, both in patients but also in mouse models that are commonly used in the preclinical setup. Here, we unveil the first pathogenic events and characterise the disease development in a mouse model for LAMA2-CMD (dy3K/dy3K), by analysing muscles at perinatal, neonatal and postnatal stages. We found that apoptotic muscle fibres were present as early as postnatal day 1. Other typical dystrophic hallmarks (muscle degeneration, inflammation, and extensive production of the extracellular matrix proteins) were clearly evident already at postnatal day 4, and the highest degree of muscle deterioration was reached by day 7. Interestingly, the severe phenotype of limb muscles partially recovered on days 14 and 21, despite worsening of the general condition of the dy3K/dy3K mouse by that age. We found that masticatory muscles were severely affected in dy3K/dy3K mice and this may be an underlying cause of their malnutrition, which contributes to death around day 21. We also showed that several signalling pathways were affected already in 1-day-old dy3K/dy3K muscle. Therapeutic tests in the dy3K/dy3K mouse model should therefore be initiated shortly after birth, but should also take into account timing and correlation between regenerative and pathogenic events.