Search

Purpose: There is growing recognition of the importance of managing sleep disorders in the elderly, particularly given their complexity within a multidimensional framework. The aim of the present study is to investigate whether sleep quality and daytime sleepiness are associated with the risk of falls in older adults., Methods: This study included patients aged 75 years or older who were consecutively evaluated at the Geriatric Service, University Hospital of Monserrato, Cagliari, Italy. Participants underwent geriatric assessment, including sleep analysis using the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS), as well as an assessment of risk of falls with Performance Oriented Mobility Assessment (POMA)., Results: The study included 206 subjects, of whom 70.4% were women, with a median age of 83 years. A total of 141 participants (68.4%) had poor sleep quality, and 43 (20.9%) had excessive daytime sleepiness (EDS). Among people at high risk of falls, 85 participants had bad sleep quality, and 24 a satisfying one (χ 2 : 8.23, p = 0.0029); additionally, 77 participants did not exhibit daytime sleepiness, while 32 did (χ 2 : 9.03, p = 0.0027). To further explore these results, we designed logistic regressions, considering dichotomized PSQI and dichotomized ESS as independent variables, and dichotomized POMA as the dependent variable, and finally adjusted them for confounders. The adjusted model for PSQI yielded OR: 2.04 (95%CI 1.02-4.10), and the adjusted model for ESS yielded OR: 2.56 (95%CI 1.17-5.91)., Conclusions: Our study demonstrated that an increased estimated risk of falling is associated with poor sleep quality and EDS in older adults, independently of the confounders., (© 2024. The Author(s), under exclusive licence to European Geriatric Medicine Society.)

Background and Objectives : Sex differences are unclear in geriatric sleep medicine, and most evidence comes from inference from preclinical bases or clinical studies conducted on younger people. The aim of this study is to explore sex differences in sleep quality and daytime sleepiness in a cohort of elderly people. Materials and Methods : This cross-sectional study involved subjects aged 65 years or older undergoing multidimensional evaluation, including sleep quality and daytime sleepiness assessment with validated tools. Results : This study included 226 subjects (69.5% women), the majority of whom showed poor sleep quality (64.2%). A logistic regression model put one before the other sleep quality and gender. It initially showed that men were about half likely as women to have poor sleep quality (OR 0.48, 95%CI 0.27-0.86). Nonetheless, after adjusting for cognitive status and mood, the difference became smaller and insignificant (OR 0.72, 95%CI 0.38-1.38). Conclusions : Sex differences in elderly people's sleep quality seem to not be independent, appearing to be affected by alterations in cognitive status and mood.

Puerto de Cajas serves as a vital high-altitude passage in Ecuador, connecting the coastal region to the city of Cuenca. The stability of this rocky massif is carefully managed through the assessment of blocks and discontinuities, ensuring safe travel. This study presents a novel approach, employing rapid and cost-effective methods to evaluate an unexplored area within the protected expanse of Cajas. Using terrestrial photogrammetry and strategically positioned geomechanical stations along the slopes, we generated a detailed point cloud capturing elusive terrain features. We have used terrestrial photogrammetry for digitalization of the slope. Validation of the collected data was achieved by comparing directional data from Cloud Compare software with manual readings using a digital compass integrated in a phone at control points. The analysis encompasses three slopes, employing the SMR, Q-slope, and kinematic methodologies. Results from the SMR system closely align with kinematic analysis, indicating satisfactory slope quality. Nonetheless, continued vigilance in stability control remains imperative for ensuring road safety and preserving the site's integrity. Moreover, this research lays the groundwork for the creation of a publicly accessible 3D repository, enhancing visualization capabilities through Google Virtual Reality. This initiative not only aids in replicating the findings but also facilitates access to an augmented reality environment, thereby fostering collaborative research endeavors.

A timely detection of visual hemifield deficits (VHFDs; hemianopias or quadrantanopias) is critical for both the diagnosis and treatment of stroke patients. The present study determined the sensitivity and specificity of four qualitative visual field tests, including face description, confrontation tests (finger wiggle), and kinetic boundary perimetry, to screen large and dense VHFDs in right-brain-damaged (RBD) stroke patients. Previously, the accuracy of qualitative visual field tests was examined in unselected samples of patients with heterogeneous aetiology, in which stroke patients represented a very small fraction. Building upon existing tests, we introduced some procedural ameliorations (incl. a novel procedure for kinetic boundary perimetry) and provided a scoresheet to facilitate the grading. The qualitative visual field tests' outcome of 67 consecutive RBD stroke patients was compared with the standard automated perimetry (SAP; i.e., reference standard) outcome to calculate sensitivity and specificity, as well as positive and negative predictive values (PPV and NPV), both for each individual test and their combinations. The face description test scored the lowest sensitivity and NPV, while the kinetic boundary perimetry scored the highest. No test returned false positives. Combining the monocular static finger wiggle test (by quadrants) and the kinetic boundary perimetry returned the highest sensitivity and specificity, in line with previous studies, but with higher accuracy (100% sensitivity and specificity). These findings indicate that the combination of these two tests is a valid approach with RBD stroke patients, prompting referral for a formal visual field examination, and representing a quick, easy-to-perform, and inexpensive tool for improving their care and prognosis.

Adequate housing protects from diarrhea, which is a substantial health concern in low- and middle-income countries. The purpose of this study was to quantify the relationship between severe diarrhea and housing features at the municipal level to help in public health planning. Regression analyses were performed on annual (2000-2012) datasets on Brazilian municipalities (5570) in six household feature categories (e.g., waste management) and four severe diarrhea outcomes (e.g., diarrhea deaths of under-5 children). Household data were not available elsewhere of this magnitude and granularity, highlighting the scientific value-add of this study. Municipalities were clustered prior to regression analysis because of data heterogeneity. The compositional household feature data were also subjected to principal component analysis to diminish feature variable multicollinearity. The highest explanatory power was found for diarrhea deaths of under-5 children (R 2  = 10-22 %), while those in the over-5 population were the least best explained (R 2  = 0.3-7 %). Household features predicted diarrhea outcomes more accurately in the "advanced" housing municipality cluster (R 2  = 16-22 %) than in the "mid-level" (R 2  = 7-20 %) and "basic" (R 2  = 6-12 %) ones (over-5 diarrhea deaths excluded). Under-5 children's diarrhea death prevalence was three times higher in the "basic" cluster than in the "advanced" cluster. Importantly, the impact of waste management was overall the largest of all household features, even larger than those of WASH, i.e., water supply, sanitation, and household drinking water treatment. This is surprising in the context of existing literature because WASH is generally regarded as the most important household factor affecting gastrointestinal health. In conclusion, public health interventions could benefit from customizing interventions for diarrhea outcomes, municipality types, and household features. Waste management's identified stronger association with diarrhea compared to WASH may have important implications beyond the water field and Brazil., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Modeling phenological phases in a Mediterranean environment often implies tangible challenges to reconstructing regional trends over heterogenous areas using limited and scattered observations. The present investigation aimed to project phenological phases (i.e., sprouting, blooming, and pit hardening) for early and mid-late olive cultivars in the Mediterranean, comparing two phenological modeling approaches. Phenoflex is a rather integrated but data-demanding model, while a combined model of chill and anti-chill days and growing degree days (CAC_GDD) offers a more parsimonious and general approach in terms of data requirements for parameterization. We gathered phenological observations from nine experimental sites in Italy and temperature timeseries from the European Centre for Medium-Range Weather Forecasts, Reanalysis v5. The best performances of the CAC_GDD (RMSE: 4 days) and PhenoFlex models (RMSE: 5-9.5 days) were identified for the blooming and sprouting phases of mid-late cultivars, respectively. The CAC_GDD model was better suited to our experimental conditions for projecting pit hardening and blooming dates (correlation: 0.80 and 0.70, normalized RMSE: 0.6 and 0.8, normalized standard deviation: 0.9 and 1.0). The optimization of the principal parameters confirmed that the mid-late cultivars were more adaptable to thermal variability. The spatial distribution illustrated the near synchrony of blooming dates between the early and mid-late cultivars compared to other phases.

Stroke survivors with right-brain damage (RBD) often present with attentional deficits such as left unilateral spatial neglect. Some patients also present with contralesional visual hemi-field deficits. A late detection of visual hemi-field deficits (VHFD) contributes to hampering neurorehabilitation and functional outcome of patients with neglect. The Brentano Illusion Test (BRIT) may be used for an early detection of VHFD during the neuropsychological assessment. In the present study, we determined the sensitivity and specificity of the BRIT for screening VHFD in patients with neglect. Sixty-four consecutive RBD patients were examined. Forty-five presented with neglect. Of these, 23 presented with VHFD (hemianopia or quadrantanopia) as detected by the Humphrey automated static visual field testing (reference standard). Consecutive patients also included 19 participants without neglect, who did not have any VHFD. The sensitivity and specificity of the BRIT for neglect patients were 78.3% (95% CI: 61.4-95.1) and 90.9 (95% CI: 78.9-100.0), respectively. Positive predictive value (PPV) was 89.6% (95% CI: 76.4-100.0); negative predictive value (NPV) 80.7% (95% CI: 65.2-96.2). No false positives in the group without neglect were identified. We conclude that the BRIT is an effective tool for clinical neuropsychologists to screen for possible VHFD in neglect patients during the neuropsychological assessment, allowing the refinement of the clinical picture in the neuropsychological report. An early detection of VHFD also allows referring the patient to standard diagnostics for a formal visual field examination, right from the first neuropsychological assessment.

The seagrass Halophila stipulacea is native to the Red Sea. It invaded the Mediterranean over the past century and most of the Caribbean over the last two decades. Understanding the main drivers behind the successful invasiveness of H. stipulacea has become crucial. We performed a comprehensive study including field measurements, a mesocosm experiment, and a literature review to identify 'superior growth traits' that can potentially explain the success story of H. stipulacea . We assessed meadow characteristics and plant traits of three invasive H. stipulacea populations growing off the Island of Sint Eustatius (eastern Caribbean). We compared similar parameters between native (Eilat, northern Red Sea) and invasive (Caribbean)  H. stipulacea plants in a common-garden mesocosm. Lastly, we compared our field measurements with published data. The newly arrived H. stipulacea plants from St. Eustatius were characterized by higher percent cover, higher below- and above-ground biomasses, more apical shoots, and faster leaf turnover rates than those measured in both native and older invaded habitats. These results were further confirmed by the mesocosm experiment where the invasive H. stipulacea plants grew faster and developed more apical shoots than the native plants. Results suggest that increased growth vigour is one of the main invasive traits that characterize successful invasive H. stipulacea populations in the Caribbean and potentially in other invaded areas. We encourage long-term monitoring of H. stipulacea in both native and invaded habitats to better understand the future spread of this species and its impacts on communities and their ecosystem functions and services., Supplementary Information: The online version contains supplementary material available at 10.1007/s10530-023-03045-z., Competing Interests: Conflict of interestAll authors have no relevant financial or non-financial competing interests to disclose., (© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Kelp detritus fuels coastal food webs and may play an important role as a source of organic matter for natural carbon sequestration. Here, we conducted ex situ and in situ manipulations to evaluate the role of temperature and light availability in the breakdown of detrital material. We examined degradation rates of two North Atlantic species with contrasting thermal affinities: the 'warm water' kelp Laminaria ochroleuca and the 'cool water' Laminaria hyperborea. Detrital fragments were exposed to different temperatures in controlled conditions and across an in situ gradient of depth, corresponding to light availability. Overall, degradation rates (i.e. changes in F v /F m and biomass) were faster under lower light conditions and at higher temperatures, although responses were highly variable between plants and fragments. Crucially, as L. ochroleuca degraded faster than L. hyperborea under some conditions, a climate-driven substitution of the 'cool' for the 'warm' kelp, which has been observed at some locations, will likely increase detritus turnover rates and alter detrital pathways in certain environments. More importantly, ocean warming combined with decreased coastal water quality will likely accelerate kelp detritus decomposition, with potential implications for coastal food webs and carbon cycles., (Copyright © 2021 Elsevier Ltd. All rights reserved.)