EuGMS 2019 Congress report: evidence-based medicine in geriatrics

This is the final version. Available from Springer Nature via the DOI in this record. The 2019 EuGMS Congress “Evidence-Based Medicine in Geriatrics” was held in Krakow, Poland, and attended by over 1600 participants from 64 different countries. A summary and reflection on the congress was presented in the Closing Ceremony by European Academy for Medicine of Aging graduates, and summarised in this article. Keynote lectures, ‘state of the art’ sessions and symposia presented the evidence relating to different age-related conditions, their prevention, management and treatments. Hot topic areas included frailty and multimorbidity, and evidence-based attempts to address these conditions at different life stages. The field of geriatrics represents unique challenges for evidence-based medicine practice. There is much research going on. Clear leadership is needed to facilitate consensus agreements on standard definitions, methods and relevant outcomes, in collaboration with older people themselves, to maximise the opportunities and benefits of doing this research, and benefiting our patients and society at large

The Relevance and Added Value of Geriatric Medicine (GM): Introducing GM to Non-Geriatricians

Geriatric Medicine (GM) holds a crucial role in promoting health and managing the complex medical, cognitive, social, and psychological issues of older people. However, basic principles of GM, essential for optimizing the care of older people, are commonly unknown or undermined, especially in countries where GM is still under development. This narrative review aims at providing insights into the role of GM to non-geriatrician readers and summarizing the main aspects of the added value of a geriatric approach across the spectrum of healthcare. Health practitioners of all specialties are frequently encountered with clinical conditions, common in older patients (such as cancer, hypertension, delirium, major neurocognitive and mental health disorders, malnutrition, and peri-operative complications), which could be more appropriately managed under the light of the approach of GM. The role of allied health professionals with specialized knowledge and skills in dealing with older people’s issues is essential, and a multidisciplinary team is required for the delivery of optimal care in response to the needs and aspirations of older people. Thus, countries should assure the educational background of all health care providers and the specialized health and social care services required to meet the demands of a rapidly aging society

Stress testing diversified portfolios: the case of the CoinShares gold and cryptoassets index

Stress testing involves the use of simulation to assess the resilience of investment portfolios to changes in market regimes and extreme events. The quality of stress testing is a function of the realism of the market models employed, as well as the strategy used to determine the set of simulated scenarios. In this paper, we consider both of these parameters in the context of diversified portfolios, with a focus on the emerging class of cryptoasset-containing portfolios. Our analysis begins with univariate modelling of individual risk factors using ARMA and GJR--GARCH processes. Extreme Value Theory is applied to the tails of the standardised residuals distributions in order to account for extreme outcomes accurately. Next, we consider a family of copulas to represent the dependence structure of the individual risk factors. Finally, we combine the former approaches to generate a number of plausibility-constrained scenarios of interest, and simulate them to obtain a risk profile. We apply our methodology to the CoinShares Gold and Cryptoassets Index, a monthly-rebalanced index which comprises two baskets of risk-weighted assets: one containing gold and one containing cryptoassets. We demonstrate a superior risk-return profile as compared to investments in a traditional market-cap-weighted cryptoasset index

Performance of the CoinShares Gold and Cryptoassets Index under different market regimes

Regime-switching models are frequently used to explain the tendency of financial markets to change their behavior, often abruptly. Such changes usually translate to structural breaks in the average means and volatilities of financial indicators, and partition their time-series into distinct segments, each with unique statistical properties. In this paper, we address the problem of identifying the presence of such regimes in the constituents of diversified, cryptoasset-containing portfolios, ultimately to define high-risk market conditions and assess portfolio resilience. For each portfolio component, we first consider a Gaussian Hidden Markov Model (HMM) in order to extract intermediate trend-related states, conditional on the weekly returns distributions. We further apply a Markov-switching GARCH model to the demeaned daily returns to describe changes in the conditional variance dynamics and isolate volatility-related states. We combine the former approaches to generate a number of price paths for each constituent, simulate the portfolio allocation strategy and obtain a risk profile for each combination of the trend and volatility regimes. We apply the proposed method to the CoinShares Gold and Cryptoassets Index, a diversified, monthly-rebalanced index which includes two main risk-weighted components; a cryptoassets basket and physical gold. Results demonstrate an overall stable risk-reward profile when compared against the individual components and suggest a superior performance in terms of Omega ratio for investors that target wealth preservation and moderate annual returns. We detect underperformance regions in bear-low volatility market regimes, where diversification is hindered

Photocatalytic Hydrogen Evolution by tris-dithiolene tungsten complexes

Herein, we report on the homogeneous photocatalytic evolution of hydrogen by using as reductive catalysts the prismatic symmetric tris – dithiolene complexes of the tungsten, namely [W{S2C2(Ph)2}3] (1) and its monoanion [W{S2C2(Ph)2}3](TBA) (2). Complex 2 is fully characterized by elemental analysis, ESI-MS, IR, UV-Vis and fluorescence spectrophotometry as well as cyclic voltammetry. The photocatalytic system consists of [ReBr(CO)3(bpy)] as a photosensitizer, triethanolamine as a sacrificial electron donor and acetic acid as the proton source. Although the activity of the photocatalytic system is rather small (TON=18), it indicates that the homoleptic tris dithiolene complexes can act as proton reductive catalysts with their monoanion form to be more active in accordance with the findings for the bis - dithiolene complexes

A perspective on solar energy conversion and water photosplitting by dithiolene complexes

This review is focused on experimental work on dithiolene complexes and their usage as photocatalysts for the cleavage of water. Several aspects of homogeneous and heterogeneous photocatalysis of water with dithiolene complexes as chromophores are discussed. It is indicated that instabilities of the photocatalyst observed in homogeneous solutions can be easily overcome if an heterogeneous approach is adopted by anchoring the dithiolene catalysts on a semiconductor or by depositing them to an electrode in an electrocatalytic cell. Moreover, dithiolene complexes composed of abundant, inexpensive metals can play an important role in the reduction of water as an alternative to the most expensive platinum. © 2012 Elsevier B.V

Diversification benefits of commodities for cryptoasset portfolios

The aim for balance between risk and reward in investment portfolios often requires studying the diversification contribution of its constituents. This objective requires to specify whether investors can extend their exposure in certain asset classes and benefit their portfolios in a statistically significant way. In this paper, we address this issue of diversification in the context of cryptoasset portfolios and examine whether their risk-adjusted performance can be enhanced through seeking exposure into the commodities class. For an equally-weighted portfolio of five cryptoassets, we first consider the addition of physical gold, as conceptualised by the CoinShares Gold and Cryptoassets Index, a diversified, monthly-rebalanced index that seeks exposure to both asset classes. We further consider modifying the index composition by replacing physical gold with a basket of five commodities. Mean-variance spanning tests reveal that the addition of physical gold in the original cryptoasset portfolio translates to a significant shift in the efficient frontier, both in terms of the global minimum variance and the tangency portfolios. Additionally, expanding the exposure in the commodity side confirms a statistically significant improvement, with the diversification benefit arising from a shift in the tangency portfolio. We further generate a number of price paths for the original index, the modified index and their components, according to a Dynamic Conditional Correlation GARCH specification, to assess the efficiency of the index weighted risk contribution scheme. Results demonstrate a superior performance of the two indices when compared against their constituents in terms of Omega ratio. The modified index appears more appropriate for investors that seek higher annual returns, while the original composition would be more appropriate for individuals with moderate annual return goals

Rhenium complexes in homogeneous hydrogen evolution

This review is focused on the photocatalytic properties of the Re(I) compounds in the reduction of H+ and their use in solar energy conversion. Different systems are discussed in terms of the photosensitizer - usually containing the core [ReX(CO)3diimine]+ - and mechanistic details are provided. The effect of the axial ligand and coordination of solvent water or TEOA on hydrogen evolution rates is also discussed. Supramolecular systems that mimic enzymes by combining both the photsenzitizer and the catalyst are also presented. © 2014 Elsevier B.V

Establishing Structure–Activity Relationships in Photocatalytic Systems by Using Nickel Bis(dithiolene) Complexes as Proton Reduction Catalysts

Herein, we present an artificial photocatalytic system for H2 evolution based on a series of proton reduction catalysts, namely [Ni{S2C2(Ph)2}2] (1), [Ni{S2C2(Ph)2}2](NEt4) (1–), [Ni{S2C2(Ph)(Ph–OCH3-4)}2] (2), [Ni{S2C2(Ph)(Ph–OCH3-4)}2](NEt4) (2–), [Ni{S2C2(Ph–OCH3-4)2}2] (3) and [Ni{S2C2(Ph–OCH3-4)2}2](NEt4) (3–), [Ni(mnt)2] (NBu4) (4–), [Ni(mnt)(S2C2(Ph)2)](NBu4) (5–). These complexes are different of both in charge and the substituents on dithiolene ligand and represent a group of active catalysts for the reduction of protons with high TONs. A series of ReI complexes, [ReBr(CO)3 (bpy)], [ReCl(CO)3(bpy)], [Re(NCS)(CO3)(bpy)], [ReBr(CO)3(amphen)] and [ReBr(CO)3 (pq)] were used as photosensitizers, in combination with triethanolamine as a sacrificial electron donor and acetic acid as a proton source. The differences of the ligands in the electron donating properties and reactivity are discussed in the light of the experimental data. We also present the physicochemical characterization of a previously reported heteroleptic monoanionic complex (5–), by UV/Vis spectroscopy, FTIR spectroscopy, cyclic voltammetry and single-crystal X-ray diffraction studies. © 2019 WILEY-VCH Verlag GmbH & Co. KGaA, Weinhei

Synthesis, characterization and crystal structure of rhenium(I) tricarbonyl diimine complexes coupled with their efficiency in producing hydrogen in a photocatalytic system

Herein, we present the synthesis and characterization of two complexes, namely [ReBr(CO)3amphen] (1) (amphen = 1,10-phenanthroline-5-amine) and [ReBr(CO)3pq] (2) (pq = 2-(2′pyridyl)quinoxaline); complex 2 is reported for the first time. The X-ray crystal structure of 2 has been determined. Electrochemical and photophysical studies have been performed to study the effect of the variation of the diimine ligand on the redox and optical properties of this class of compounds. Both complexes were used as photosensitizers for hydrogen production in a homogeneous photocatalytic system also carrying [Co(dmgH)2] as a hydrogen reaction catalyst, triethanolamine as an irreversible reductive quencher and AcOH as proton source. Complex 1 produces H2 after only 2 h irradiation while complex 2 requires 24 h indicating that the differences in the electronic properties influence their photosensitizing ability