The multifaceted spectrum of liver cirrhosis in older hospitalised patients: Analysis of the REPOSI registry

Background: Knowledge on the main clinical and prognostic characteristics of older multimorbid subjects with liver cirrhosis (LC) admitted to acute medical wards is scarce. Objectives: To estimate the prevalence of LC among older patients admitted to acute medical wards and to assess the main clinical characteristics of LC along with its association with major clinical outcomes and to explore the possibility that well-distinguished phenotypic profiles of LC have classificatory and prognostic properties. Methods: A cohort of 6,193 older subjects hospitalised between 2010 and 2018 and included in the REPOSI registry was analysed. Results: LC was diagnosed in 315 patients (5%). LC was associated with rehospitalisation (age-sex adjusted hazard ratio, [aHR] 1.44; 95% CI, 1.10-1.88) and with mortality after discharge, independently of all confounders (multiple aHR, 2.1; 95% CI, 1.37-3.22), but not with in-hospital mortality and incident disability. Three main clinical phenotypes of LC patients were recognised: relatively fit subjects (FIT, N = 150), subjects characterised by poor social support (PSS, N = 89) and, finally, subjects with disability and multimorbidity (D&M, N = 76). PSS subjects had an increased incident disability (35% vs 13%, P < 0.05) compared to FIT. D&M patients had a higher mortality (in-hospital: 12% vs 3%/1%, P < 0.01; post-discharge: 41% vs 12%/15%, P < 0.01) and less rehospitalisation (10% vs 32%/34%, P < 0.01) compared to PSS and FIT. Conclusions: LC has a relatively low prevalence in older hospitalised subjects but, when present, accounts for worse post-discharge outcomes. Phenotypic analysis unravelled the heterogeneity of LC older population and the association of selected phenotypes with different clinical and prognostic features

Relativistic treatment of diamagnetic susceptibility of helium

We report theoretical calculations of the diamagnetic susceptibility, $\chi_0$, of helium atom. We determined the complete relativistic correction to $\chi_0$ of the order of $\alpha^4$, where $\alpha$ is the fine structure constant, by including all $\alpha^4$ terms originating from the Dirac and Breit equations for a helium atom in a static magnetic field. Finite nuclear mass corrections to $\chi_0$ was also evaluated. To obtain very accurate results and reliable uncertainty estimates we used a sequence of explicitly correlated basis sets of fully optimized Slater geminals. We found that $\chi_0=-2.119\,106(34)\cdot10^{-5}$ $a_0^3$ and $\chi_0=-2.119\,400(34)\cdot10^{-5}$ $a_0^3$ for $^4$He and $^3$He isotopes, respectively, where $a_0$ is the Bohr radius and the uncertainties shown in the parentheses are due entirely to the very conservative estimate of the neglected QED corrections of the order of $\alpha^5$. Our results are compared with the available experimental data and with previous, incomplete theoretical determinations of the $\alpha^4$ contributions to the diamagnetic susceptibility of helium

On the analysis of the contact angle for impacting droplets using a polynomial fitting approach

ractical considerations on the measurement of the dynamic contact angle and the spreading diameter of impacting droplets are discussed in this paper. The contact angle of a liquid is commonly obtained either by a polynomial or a linear fitting to the droplet profile around the triple phase point. Previous works have focused on quasi-static or sessile droplets, or in cases where inertia does not play a major role on the contact angle dynamics. Here, we study the effect of droplet shape, the order of the fitting polynomial, and the fitting domain, on the measurement of the contact angle on various stages following droplet impact where the contact line is moving. Our results, presented in terms of the optical resolution and the droplet size, show that a quadratic fitting provides the most consistent results for a range of various droplet shapes. As expected, our results show that contact angle values are less sensitive to the fitting conditions for the cases where the droplet can be approximated to a spherical cap. Our experimental conditions include impact events with liquid droplets of different sizes and viscosities on various substrates. In addition, validating past works, our results show that the maximum spreading diameter can be parameterised by the Weber number and the rapidly advancing contact angle

Collision-induced three-body polarizability of helium

We present first-principles theoretical determination of the three-body polarizability and the third dielectric virial coefficient of helium. Coupled-cluster theory and the full configuration interaction procedure were used to perform required electronic structure calculations. The mean absolute relative uncertainty of the trace of the three-body polarizability tensor, resulting from the incompleteness of orbital basis set, was determined using extrapolation techniques. Additional uncertainty due to approximate treatment of triple and the neglect of higher excitations was estimated using full configuration interaction calculations. An analytic function was developed to describe the behavior of the polarizability and its asymptotic decay to three-atomic and atom-diatom fragmentation channels. We also developed an analytic function describing the local behavior of the total uncertainty of our calculations. Using both fits we calculated the third dielectric virial coefficient and its uncertainty using the classical and semiclassical Feynman-Hibbs approaches. The results of our calculations were compared with available experimental data and with recent Path-Integral Monte Carlo (PIMC) calculations employing the so-called superposition approximation of the three-body polarizability. For temperatures above 200 K we observed significant discrepancy between the classical results obtained using either the superposition approximation or the ab initio computed polarizability. The theoretical data reported in this work eliminate the main accuracy bottleneck of the development of optical pressure standard and are expected to facilitate further progress in the field of quantum thermal metrologyComment: 30 pages, 7 figure

Multiscale Design And Life-Cycle Based Sustainability Assessment Of Polymer Nanocomposite Coatings

In recent years, nanocoatings with exceptionally improved and new performance properties have found numerous applications in the automotive, aerospace, ship-making, chemical, electronics, steel, construction, and many other industries. Especially the formulations providing multiple functionalities to cured paint films are believed to dominate the coatings market in the near future. It has shifted the focus of research towards building sustainable coating recipes which can deliver multiple functionalities through applied films. The challenge to this exciting area of research arrives from the insufficient knowledge about structure-property correlations of nanocoating materials and their design complexity. Experimental efforts have been successful in developing certain types of nanopaints exhibiting improved properties. However, multifunctional nanopaint design optimality is extremely difficult to address if not impossible solely through experiments. In addition to this, the environmental implications and societal risks associated with this growing field of nanotechnology raise several questions related to its sustainable development. This research focuses on the study of a multiscale sustainable nanocoating design which can have the application from novel function envisioning and idea refinement point of view, to knowledge discovery and design solution derivation, and further to performance testing in industrial applications. The nanocoating design is studied using computational simulations of nano- to macro- scale models and sustainability assessment study over the life-cycle. Computational simulations aim at integrating top-down, goals/means, inductive systems engineering and bottom-up, cause and effect, deductive systems engineering approaches for material development. The in-silico paint resin system is a water-dispersible acrylic polymer with hydrophilic nanoparticles incorporated into it. The nano-scale atomistic and micro-scale coarse-grained (CG) level simulations are performed using molecular dynamics methodology to study several structural and morphological features such as effect of polymer molecular weight, polydispersity, rheology, nanoparticle volume fraction, size, shape and chemical nature on the bulk mechanical and self-cleaning properties of the coating film. At macro-scale, a paint spray system which is used for automotive coating application is studied by using CFD-based simulation methodology to generate crucial information about the effects of nanocoating technology on environmental emissions and coating film quality. The cradle-to-grave life-cycle based sustainability assessment study address all the critical issues related to economic benefits, environmental implications and societal effects of nanocoating technology through case studies of automotive coating systems. It is accomplished by identifying crucial correlations among measurable parameters at different stages and developing sustainability indicator matrices for analysis of each stage of life-cycle. The findings from the research can have great potential to draft useful conclusions in favor of future development of coating systems with novel functionalities and improved sustainability

Pain and Frailty in Hospitalized Older Adults

Introduction: Pain and frailty are prevalent conditions in the older population. Many chronic diseases are likely involved in their origin, and both have a negative impact on quality of life. However, few studies have analysed their association. Methods: In light of this knowledge gap, 3577 acutely hospitalized patients 65 years or older enrolled in the REPOSI register, an Italian network of internal medicine and geriatric hospital wards, were assessed to calculate the frailty index (FI). The impact of pain and some of its characteristics on the degree of frailty was evaluated using an ordinal logistic regression model after adjusting for age and gender. Results: The prevalence of pain was 24.7%, and among patients with pain, 42.9% was regarded as chronic pain. Chronic pain was associated with severe frailty (OR = 1.69, 95% CI 1.38–2.07). Somatic pain (OR = 1.59, 95% CI 1.23–2.07) and widespread pain (OR = 1.60, 95% CI 0.93–2.78) were associated with frailty. Osteoarthritis was the most common cause of chronic pain, diagnosed in 157 patients (33.5%). Polymyalgia, rheumatoid arthritis and other musculoskeletal diseases causing chronic pain were associated with a lower degree of frailty than osteoarthritis (OR = 0.49, 95%CI 0.28–0.85). Conclusions: Chronic and somatic pain negatively affect the degree of frailty. The duration and type of pain, as well as the underlying diseases associated with chronic pain, should be evaluated to improve the hospital management of frail older people

Sex-Differences in the Pattern of Comorbidities, Functional Independence, and Mortality in Elderly Inpatients: Evidence from the RePoSI Register.

BACKGROUND: The RePoSi study has provided data on comorbidities, polypharmacy, and sex dimorphism in hospitalised elderly patients. METHODS: We retrospectively analysed data collected from the 2010, 2012, 2014, and 2016 data sets of the RePoSi register. The aim of this study was to explore the sex-differences and to validate the multivariate model in the entire dataset with an expanded follow-up at 1 year. RESULTS: Among 4714 patients, 51% were women and 49% were men. The disease distribution showed that diabetes, coronary artery disease, chronic obstructive pulmonary disease, chronic kidney disease, and malignancy were more frequent in men but that hypertension, anaemia, osteoarthritis, depression, and diverticulitis disease were more common in women. Severity and comorbidity indexes according to the Cumulative Illness Rating Scale (CIRS-s and CIRS-c) were higher in men, while cognitive impairment, mood disorders, and disability in daily life measured by the Barthel Index (BI) were worse in women. In the multivariate analysis, BI, CIRS, and malignancy significantly increased the risk of death in men at the 1-year follow-up, while age was independently associated with mortality in women. CONCLUSIONS: Our study highlighted the relevance and the validity of our previous predictive model in the identification of sex dimorphism in hospitalised elderly patients underscoring the need of sex-personalised health-care