Screening for elderly patients admitted to the emergency department requiring specialized geriatric care

BACKGROUND: There is a need for a brief geriatric assessment (BGA) tool to screen elderly patients admitted to the Emergency Department (ED) for their risk of a long hospital stay. OBJECTIVE: To examine whether a BGA administered to elderly patients admitted to the ED may predict the risk of a long hospital stay in the geriatric acute care unit. METHODS: This study had a prospective cohort study design, enrolling 424 elderly patients (mean age 84.0 +/- 6.5 years, 31.6% male) who were evaluated in the ED using a BGA composed of the following items: age, gender, number of medications taken daily, history of falls during the past 6 months, Mini-Mental State Examination (MMSE) score, and non-use of home-help services (i.e., living alone without using any formal or informal home services or social help). The length of stay (LOS) was calculated in days. Patients were separated into three groups based on LOS: low (<8 days), intermediate (8-13 days), and high (>13 days). RESULTS: The prevalence of male gender was higher among patients with the longest LOS compared to those with intermediate LOS (p = 0.002). There were more patients with a history of falls in the high LOS group compared to the intermediate LOS group (p = 0.001) and the low LOS group (p < 0.001). The classification tree showed that male patients with an MMSE score <20 who fell with age under 85 years formed the end node with the greatest relative risk (RR) of a long hospital stay (RR = 14.3 with p < 0.001). CONCLUSIONS: The combination of a history of falls, male gender, cognitive impairment, and age under 85 years identified elderly ED patients at high risk of a long hospital stay

Association between vitamin D deficiency and long hospital stay in geriatric acute care unit: results from a pilot cohort study

Finding a biomarker of long length-of-stay (LOS) would provide a simple solution to target frail older inpatients at such risk. The aim of this study was to determine whether serum 25-hydroxyvitamin D (25OHD) deficiency, defined as serum concentration <25 nmol/L, was associated with long LOS among inpatients admitted to a geriatric acute care unit. Three hundred and six older inpatients (mean age 84.6 +/- 6.4 years, 61.8 % women) were consecutively included in this longitudinal prospective cohort study. Patients were separated into two groups according to LOS tertiles: highest tertile (>= 14 days; n = 120) versus the other two tertiles combined (<14 days; n = 186). Serum 25OHD deficiency (58.3 vs. 38.7 %, P = 0.001) and the prevalence of male gender (58.3 vs. 28.5 %, P < 0.001) were higher among inpatients with the highest LOS compared with those with lower LOS. Serum 25OHD deficiency [odds ratio (OR) = 2.22, P = 0.001 for unadjusted model; OR = 1.87, P = 0.012 for fully adjusted model) and male gender (OR = 2.87, P < 0.001 for unadjusted model; OR = 2.64, P = 0.001 for full model) were associated with a high LOS. Vitamin D deficiency and male gender were risk factors for a long LOS in this pilot study. Using these risk factors to identify inpatients at risk of long LOS may be helpful in adapting early care plans, and thus improving inpatients\u27 health and shortening LOS

Transport and cooling of singly-charged noble gas ion beams

The transport and cooling of noble gas singly-charged ion beams by means of a Radio Frequency Quadrupole Cooler Buncher (RFQCB) have been studied at the LIMBE low energy beam line of the GANIL facility. Ions as light as $^{4}He^+$ have been cooled and stored before their extraction in bunches using $H_2$ as buffer gas. Bunches characteristics have been studied as a function of the parameters of the device. Sizeable transmissions of up to 10 $$ have been obtained. A detailed study of the lifetime of ions inside the buncher has been performed giving an estimate of the charge exchange cross-section. Results of a microscopic Monte-Carlo transport code show reasonable agreement with experimental data.Comment: 13 figure

MONOBOB II : Latest results of monocharged ions source for SPIRAL2 project

Original publication available at http://www.jacow.orgInternational audienceAmong the sources which can be installed in the radioactive ion production module of SPIRAL II, a singly-charged ECRIS has been chosen to produce ions from gaseous elements. Its characterization is under way on a test bench at GANIL. Extraction, transport and response time results are presented

Production of multi-charged phosphorus ions with ecris 'SUPERSHyPIE' at GANIL

The Ganil's Ion Production Group tested the source SUPERSHyPIE123 for theproduction of phosphorus n+ ion beams. The SUPERSHyPIE ecris is used for many testsof multi-charged ion production and supply ion beams for LIMBE4 (low energie beamline). This ion source works with a 14.5ghz RF power injected by a circular waveguide inthe axis of the sourc

Nuclear structure and reaction studies at SPIRAL

The SPIRAL facility at GANIL, operational since 2001, is described briefly. The diverse physics program using the re-accelerated (1.2 to 25 MeV/u) beams ranging from He to Kr and the instrumentation specially developed for their exploitation are presented. Results of these studies, using both direct and compound processes, addressing various questions related to the existence of exotic states of nuclear matter, evolution of new "magic numbers", tunnelling of exotic nuclei, neutron correlations, exotic pathways in astrophysical sites and characterization of the continuum are discussed. The future prospects for the facility and the path towards SPIRAL2, a next generation ISOL facility, are also briefly presented.Comment: 48 pages, 27 figures. Accepted for publication in Journal of Physics

Visible light spectrometry measurements for studying an ECRIS plasma and especially applied to the MONO1001 ion source

International audienceThe cylindrical geometry of the magnetic confinement of the MONO1001 ECR ion sourcemade in GANIL1, allows us to measure radial characteristics of the working ECR plasmawith Helium gas. The physical and the geometrical characteristics of the resonance surfaceinside the working ECR source have been quantified with the help of a visible lightspectrometer. Hence, we have deduced a shape of the ECRIS resonance surface whichcorresponds closely to our magnetic calculations

MONO 1001

La source d’ions monochargés MONO 1001 en développement au GANIL, est de type ECR etfonctionne à 2.45ghz.La source MONO1001 a été testée avec les éléments suivants: Hélium, Argon, Néon, krypton,xénon, hydrogène, fer (méthode MIVOC), calcium, erbium, plomb et fullerene (à partir d’une sourced’évaporation), soufre (à partir de SO2 ou SF6)

Brainstem Respiratory Oscillators Develop Independently of Neuronal Migration Defects in the Wnt/PCP Mouse Mutant looptail

The proper development and maturation of neuronal circuits require precise migration of component neurons from their birthplace (germinal zone) to their final positions. Little is known about the effects of aberrant neuronal position on the functioning of organized neuronal groups, especially in mammals. Here, we investigated the formation and properties of brainstem respiratory neurons in looptail (Lp) mutant mice in which facial motor neurons closely apposed to some respiratory neurons fail to migrate due to loss of function of the Wnt/Planar Cell Polarity (PCP) protein Vangl2. Using calcium imaging and immunostaining on embryonic hindbrain preparations, we found that respiratory neurons constituting the embryonic parafacial oscillator (e-pF) settled at the ventral surface of the medulla in Vangl2Lp/+ and Vangl2Lp/Lp embryos despite the failure of tangential migration of its normally adjacent facial motor nucleus. Anatomically, the e-pF neurons were displaced medially in Lp/+ embryos and rostro-medially Lp/Lp embryos. Pharmacological treatments showed that the e-pF oscillator exhibited characteristic network properties in both Lp/+ and Lp/Lp embryos. Furthermore, using hindbrain slices, we found that the other respiratory oscillator, the preBötzinger complex, was also anatomically and functionally established in Lp mutants. Importantly, the displaced e-pF oscillator established functional connections with the preBötC oscillator in Lp/+ mutants. Our data highlight the robustness of the developmental processes that assemble the neuronal networks mediating an essential physiological function