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Objectives: Frailty is a relevant issue in older people, being associated with several negative outcomes. Increasing literature is reporting that pollution (particularly air pollution) can increase the risk of frailty, but the research is still limited. We aimed to investigate the potential association of pollution (air, noise) with frailty and prefrailty among participants 60years and older of the UK Biobank study. Design: Cross-sectional. Settings and participants: Older participants (age ≥ 60years) participating to the UK Biobank. Methods: Frailty and prefrailty presence were ascertained using a model including 5 indicators (weakness, slowness, weight loss, low physical activity, and exhaustion). Air pollution was measured through residential exposures to nitrogen oxides (NOx) and particulate matter (PM2.5, PM2.5-10, PM10). The average residential sound level during the daytime, the evening, and night was used as an index for noise pollution. Results: A total of 220,079 subjects, aged 60years and older, was included. The partial proportional odds model, adjusted for several confounders, showed that the increment in the exposure to NOx was associated with a higher probability of being in both the prefrail and frail category [odds ratio (OR) 1.003; 95% CI 1.001-1.004]. Similarly, the increase in the exposure to PM2.5-10 was associated with a higher probability of being prefrail and frail (OR 1.014; 95% CI 1.001-1.036), such as the increment in the exposure to PM2.5 that was associated with a higher probability of being frail (OR 1.018; 95% CI 1.001-1.037). Conclusions and implications: Our study indicates that the exposure to air pollutants as PM2.5, PM2.5-10, or NOx might be associated with frailty and prefrailty, suggesting that air pollution can contribute to frailty and indicating that the frailty prevention and intervention strategies should take into account the dangerous impact of air pollutants.

Objective: Data on prognostic tools for indicating mechanical ventilation in older people with COVID-19 are still limited. The aim of this research was to evaluate if the Multidimensional Prognostic Index (MPI), based on the Comprehensive Geriatric Assessment (CGA), may help physicians in identifying older hospitalized patients affected by COVID-19 who might benefit from mechanical ventilation.Design: Longitudinal, multicenter study.Settings and Participants: 502 older people hospitalized for COVID-19 in 10 European hospitals.Methods: MPI was calculated using 8 different domains typical of the CGA. A propensity score, Cox's regression analysis was used for assessing the impact of mechanical ventilation on rehospitalization/mortality for 90 days' follow-up, stratified by MPI = 0.50. The accuracy of MPI in predicting negative outcomes (ie, rehospitalization/mortality) was assessed using the area under the curve (AUC), and the discrimination with several indexes like the Net Reclassification Improvement (NRI) and the Integrated Discrimination Improvement (IDI).Results: Among 502 older people hospitalized for COVID-19 (mean age: 80 years), 152 were treated with mechanical ventilation. In the propensity score analysis, during the 90-day follow-up period, there were 44 rehospitalizations and 95 deaths. Mechanical ventilation in patients with MPI values >= 0.50, indicating frailer participants, was associated with a higher risk of rehospitalization/mortality (hazard ratio 1.56, 95% CI 1.09-2.23), whereas in participants with MPI values < 0.50 this association was not significant. The accuracy of the model including age, sex, respiratory parameters, and MPI was good (AUC = 0.783) as confirmed by an NRI of 0.2756 (P < .001) and an IDI of 0.1858 (P < .001), suggesting a good discrimination of the model in predicting negative outcomes.Conclusions and Implications: MPI could be useful for better individualizing older people hospitalized by COVID-19 who could benefit from mechanical ventilation. (C) 2022 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

Background-\ud \ud Cross-sectional studies have demonstrated that multimorbidity is associated with sarcopenia. However, to date, this association has not been extensively investigated longitudinally. Therefore, the aim of the present paper was to explore the association between multimorbidity at baseline and sarcopenia onset over 12 years of follow-up in a large representative sample of the English older adult population.\ud \ud Methods-\ud \ud Representative data from the English Longitudinal Study of Ageing (ELSA) were analyzed. Multimorbidity at baseline was defined as ≥2 medical conditions, of 17 conditions included. Participants were considered to have sarcopenia if they had low handgrip strength and skeletal muscle mass (i.e., lower skeletal mass index) at waves 4, 6, 8. Multivariable logistic regression analysis was conducted to assess prospective associations between multimorbidity at baseline and sarcopenia at follow-up.\ud \ud Results-\ud \ud 2873 older participants (mean age: 69.1 years, 54% females) who did not have sarcopenia at baseline were included. The prevalence of multimorbidity at baseline was 57.3%. Over twelve years of follow-up, 394 participants (=13.7% of the initial population) became sarcopenic. The presence of multimorbidity at baseline was associated with an increased risk of sarcopenia during follow-up (OR = 2.06; 95%CI: 1.61–2.62) in the univariable analysis, and even after adjusting for multiple potential confounders (OR = 1.23; 95%CI: 1.01–1.61).\ud \ud Conclusions-\ud \ud In this large representative sample of older adults from the UK, multimorbidity at baseline was associated with a higher risk of sarcopenia during twelve-year follow-up. It may be prudent to target those with multimorbidity to aid in the prevention of sarcopenia.

The isotope used in this research was supplied by the United States Department of Energy Office of Science by the Isotope Program in the Office of Nuclear Physics., The neutron capture cross section of 154Gd was measured from 1 eV to 300 keV in the experimental area located 185 m from the CERN n_TOF neutron spallation source, using a metallic sample of gadolinium, enriched to 67% in 154Gd. The capture measurement, performed with four C6D6 scintillation detectors, has been complemented by a transmission measurement performed at the GELINA time-of-flight facility (JRC-Geel), thus minimising the uncertainty related to sample composition. An accurate Maxwellian averaged capture cross section (MACS) was deduced over the temperature range of interest for s process nucleosynthesis modelling. We report a value of 880(50) mb for the MACS at kT = 30 keV, significantly lower compared to values available in literature. The new adopted 154Gd(n,γ ) cross section reduces the discrepancy between observed and calculated solar s-only isotopic abundances predicted by s-process nucleosynthesis models., EUFRAT open access programme of the Joint Research Centre at Geel

Institutionalization is generally a consequence of functional decline driven by physical limitations, cognitive impairments, and/or loss of social supports. At this stage, intervention to reverse functional losses is often too late. To be more effective, geriatric medicine must evolve to intervene at an earlier stage of the disability process. Could nursing homes (NHs) transform from settings in which many residents dwell to settings in which the NH residents and those living in neighboring communities benefit from staff expertise to enhance quality of life and maintain or slow functional decline? A task force of clinical researchers met in Toulouse on December 2, 2015, to address some of these challenges: how to prevent or slow functional decline and disabilities for NH residents and how NHs may promote the prevention of functional decline in community-dwelling frail elderly. The present article reports the main results of the Task Force discussions to generate a new paradigm. Sin financiación 5.325 JCR (2017) Q1, 4/53 Geriatrics & Gerontology UEM

Sexuality is a dimension that concerns human health with profound implications not only in the biological and psychological aspects, but also in the social and cultural dimensions, affecting all ages of life. Sexuality in old age is still conditioned by biases, prejudices and from a stereotyped vision, which considered older people as “asexual”, in spite of several studies and surveys showing that older persons have sexual potential to express. In population surveys, a fair number of men and women aged over 60 years reported having sex at least once a month. The most influential predictor of sexual activity seems to be the physical health in older men, and the quality of the relationship in older women. The most common sexual disorders are erectile dysfunction and delayed ejaculation in older men, and reduced sexual interest, arousal disorder, female orgasmic disorder, genitopelvic pain and ailments of penetration in older women. A careful evaluation can identify the presence and severity of disorders in different phases of the sexual response cycle. The management of sexual dysfunction in older people may include reassurance, education, sex therapy and/or the use of drugs in specific cases. Sexuality in patients with dementia may arise as inappropriate sexual behaviour (ISB) due to behavioural disinhibition. Manifestations of ISB can be very distressing for family members and other caregivers and can present substantial challenges for staff and health care providers in long term care. Although there is no established treatment algorithm for dementia-related ISB, there are various non-pharmacological and pharmacological treatments, which can help in the management of these patients.

Sarcopenia is a common condition in older people and increasing evidence suggests that it can be considered as a potential risk factor for falls and fractures. However, no studies on this topic from low- and middle-income countries (LMICs) are available. Thus, we assessed this association among older adults from five LMICs (China, India, Ghana, Mexico, and Russia). Community-based, nationally representative, cross-sectional data of the Study on Global Aging and Adult Health were analyzed. Sarcopenia was defined as the presence of low skeletal muscle mass based on indirect population formula, and either slow gait or low handgrip strength. The presence of fall-related injury was ascertained through self-reported information. Multivariable logistic regression analysis and meta-analysis were conducted. The sample consisted of 13,101 individuals aged =65 years (mean (SD) age 72.6 (11.3) years; 45% males). The prevalence of fall-related injury was higher among those with sarcopenia than in those without this condition (e.g., Mexico 9.8% vs. 2.7%). Adjusted analyses showed that sarcopenia was associated with a 1.85 (95%CI = 1.24-2.77) times higher odds for fall-related injury, with a low level of between-country heterogeneity. Future studies of longitudinal design may shed light on whether sarcopenia in LMICs may be considered as a risk factor for falls.

Since 2001, the scientific programme of the CERN n_TOF facility has focused mainly on the study of radiative neutron capture reactions, which are of great interest to nuclear astrophysics and on neutron-induced fission reactions, which are of relevance for nuclear technology, as well as essential for the development of theoretical models of fission. In particular, taking advantage of the high instantaneous neutron flux and high energy resolution of the facility, as well as of high-performance detection and acquisition systems, accurate new measurements on several long-lived major and minor actinides, from 232 Th to 245 Cm, have been performed so far. Data on these isotopes are needed in order to improve the safety and efficiency of conventional reactors, as well as to develop new systems for nuclear energy production and treatment of nuclear waste, such as Generation IV reactors, Accelerator Driven Systems and reactors based on innovative fuel cycles. A review of the most important results on fission cross-sections and fragment properties obtained at n_TOF for a variety of (radioactive) isotopes is presented along with the perspectives arising from the coming on line in the second half of 2014 of a new 19 m flight-path, which will allow n_TOF to expand its measurement capabilities to even more rare or short-lived isotopes, such as 230 Th, 232 U, 238,240 Pu and 244 Cm.

The capture cross sections of 241Am and 243Am were measured at the n_TOF facility at CERN in the epithermal energy range with a BaF2 Total Absorption Calorimeter. A preliminary analysis of the 241Am and a complete analysis of the 243Am measurement, including the data reduction and the resonance analysis, have been performed., JRC.D.4-Standards for Nuclear Safety, Security and Safeguards

54 Fe and 57 Fe are stable iron isotopes, which play an important role in the nucleosynthesis of the slow neutron capture process ( s process). In addition, these nuclei are present in many structural materials, and therefore, the knowledge of their neutron capture cross sections is of importance for reactor design studies. This contribution summarizes the results of the ( n , γ ) cross sections of these two isotopes in the resolved resonance region. The experiment was carried out at the CERN n_TOF facility using the Pulse-Height Weighting Technique in combination with an experimental set-up optmized for reducing neutron induced backgrounds.

Objective. Several alterations of magnesium metabolism have been associated with type 2 diabetes pathophysiology, a condition particularly frequent in older persons. We aimed to evaluate serum total (Mg-tot) and serum ionized magnesium (Mg-ion) in older persons with type 2 diabetes in order to explore clinically applicable methods for the detection of magnesium deficit. Material/Methods: Mg-tot and Mg-ion were measured in 105 fasting subjects with type 2 diabetes (mean age: 71.10.8 years; M/F: 45/60) and in 100 age-matched non-diabetic control persons (mean age: 72.20.8 years; M/F: 42/58). Results: Mg-ion concentrations were significantly lower in diabetic persons compared with controls (0.490.05 mmol/L vs. 0.550.05 mmol/L; p

A fission reaction chamber based on Parallel Plate Avalanche Counters (PPACs) was built for measuring angular distributions of fragments emitted in neutron-induced fission of actinides at the neutron beam available at the Neutron Time-Of-Flight (n_TOF) facility at CERN. The detectors and the samples were tilted 45 degrees with respect to the neutron beam direction to cover all the possible values of the emission angle of the fission fragments. The main features of this setup are discussed and results on the fission fragment angular distribution are provided for the Th-232(n,f) reaction around the fission threshold. The results are compared with the available data in the literature, demonstrating the good capabilities of this setup. (C) 2014 Elsevier B.V. All rights reserved. A fission reaction chamber based on Parallel Plate Avalanche Counters (PPACs) was built for measuring angular distributions of fragments emitted in neutron-induced fission of actinides at the neutron beam available at the Neutron Time-Of-Flight (n-TOF) facility at CERN. The detectors and the samples were tilted 45 with respect to the neutron beam direction to cover all the possible values of the emission angle of the fission fragments. The main features of this setup are discussed and results on the fission fragment angular distribution are provided for the 232Th(n,f) reaction around the fission threshold. The results are compared with the available data in the literature, demonstrating the good capabilities of this setup. © 2014 Elsevier B.V.

It is generally considered that changes in serum phosphate levels do not alter parathyroid hormone (PTH) secretion in the absence of concomitant changes in ionized serum calcium level in humans. An acute rise in PTH was shown after phosphate administration by intraduodenal gavage in rats. We aimed to study gastrin, phosphate, PTH, ionized calcium (iCa), and blood pH responses to oral peptones in morbidly obese patients before and after roux-en-Y gastric bypass (RYGB) surgery.These parameters were evaluated in response to an oral peptone load in 24 (18 male and 6 female) obese subjects before and 6 months after RYGB surgery. In 12 gastric bypass patients, we also evaluated PTH and phosphate after peptones plus aluminum hydroxide administration to suppress phosphate absorption.Before RYGB, peptones increased gastrin (P.001), and decreased iCa (P.01) without changes in PTH or pH. Both phosphate and PTH markedly increased after RYGB with the peptones oral load (P.01), without changes in pH, iCa, or gastrin. There was a significant, direct relationship between the increase of phosphate and the increase of PTH in the patients treated with aluminum hydroxide (r(2) = 0.78; P.0001).Rapid delivery of peptones in the jejunum in bypassed obese patients results in a significant rise in phosphate and PTH, in the absence of changes of other PTH regulators, possibly mediated by a signaling from the gastrointestinal tract. RYGB patients provide an opportunity to study the control of PTH secretion, with potential relevant clinical implications.

BACKGROUND The role of magnesium in maintaining muscle integrity and function in older adults is largely unknown. OBJECTIVE We aimed to investigate the relation between serum magnesium concentrations and muscle performance in older subjects. DESIGN Data are from the baseline examination conducted between September 1998 and March 2000 of the InCHIANTI (aging in the Chianti area) study, a prospective epidemiologic survey of risk factors for late-life disability. From among 1453 randomly selected community residents completing a home interview, 1138 men (46%) and women (aged 66.7 +/- 15.2 y; x +/- SD) with complete data on muscle performance and serum magnesium who were not severely cognitively compromised and had no evidence of kidney disease or hypercalcemia were included in the analysis. Muscle performance was evaluated by grip strength, lower-leg muscle power, knee extension torque, and ankle extension isometric strength and was normalized for age and body mass index (BMI) within each sex. RESULTS After adjustment for age, sex, BMI, laboratory variables, presence of chronic diseases, muscle area, muscle density, and physical activity level, serum magnesium concentrations were significantly associated with indexes of muscle performance, including grip strength (beta = 2.0 +/- 0.5, P = 0.0002), lower-leg muscle power (beta = 8.8 +/- 2.7, P = 0.001), knee extension torque (beta = 31.2 +/- 7.9, P < 0.0001), and ankle extension strength (beta = 3.8 +/- 0.5, P < 0.0001). CONCLUSIONS The serum magnesium concentration is an independent correlate of muscle performance in older persons. Whether magnesium supplementation improves muscle function remains to be shown.

Magnesium (Mg) is one of the most abundant ions present in living cells and its plasma concentration is remarkably constant in healthy subjects. Plasma and intracellular Mg concentrations are tightly regulated by several factors. Among them, insulin seems to be one of the most important. In vitro and in vivo studies have demonstrated that insulin may modulate the shift of Mg from extracellular to intracellular space. Intracellular Mg concentration has also been shown to be effective in modulating insulin action (mainly oxidative glucose metabolism), offset calcium-related excitation-contraction coupling, and decrease smooth cell responsiveness to depolarizing stimuli. A poor intracellular Mg concentration, as found in noninsulin-dependent diabetes mellitus (NIDDM) and in hypertensive patients, may result in a defective tyrosine-kinase activity at the insulin receptor level and exaggerated intracellular calcium concentration. Both events are responsible for the impairment in insulin action and a worsening of insulin resistance in noninsulin-dependent diabetic and hypertensive patients. By contrast, in NIDDM patients daily Mg administration, restoring a more appropriate intracellular Mg concentration, contributes to improve insulin-mediated glucose uptake. The benefits deriving- from daily Mg supplementation in NIDDM patients are further supported by epidemiological studies showing that high daily Mg intake are predictive of a lower incidence of NIDDM. In conclusion, a growing body of studies suggest that intracellular Mg may play a key role in modulating insulin-mediated glucose uptake and vascular tone. We further suggest that a reduced intracellular Mg concentration might be the missing link helping to explain the epidemiological association between NIDDM and hypertension.