Coherent phonons and the interplay between charge density wave and Mott phases in 1TT-TaSe2_{2}

1$T$-TaSe$_{2}$ is host to coexisting strongly-correlated phases including charge density waves (CDWs) and an unusual Mott transition at low temperature. Here, we investigate coherent phonon oscillations in 1$T$-TaSe$_{2}$ using a combination of time- and angle-resolved photoemission spectroscopy (TR-ARPES) and time-resolved reflectivity (TRR). Perturbation by a femtosecond laser pulse triggers a modulation of the valence band binding energy at the $\Gamma$-point, related to the Mott gap, that is consistent with the in-plane CDW amplitude mode frequency. By contrast, TRR measurements show a modulation of the differential reflectivity comprised of multiple frequencies belonging to the distorted CDW lattice modes. Comparison of the temperature dependence of coherent and spontaneous phonons across the CDW transition shows that the amplitude mode intensity is more easily suppressed during perturbation of the CDW state by the optical excitation compared to other modes. Our results clearly identify the relationship of the in-plane CDW amplitude mode with the Mott phase in 1$T$-TaSe$_{2}$ and highlight the importance of lattice degrees of freedom.Comment: 7 pages, 4 figures, supplemental materia

From Listing to Recovery: A Review of Nutritional Status Assessment and Management in Liver Transplant Patients

Liver transplantation (LT) is a complex surgical procedure requiring thorough pre- and post-operative planning and care. The nutritional status of the patient before, during, and after LT is crucial to surgical success and long-term prognosis. This review aims to assess nutritional status assessment and management before, during, and after LT, with a focus on patients who have undergone bariatric surgery. We performed a comprehensive topic search on MEDLINE, Ovid, In-Process, Cochrane Library, EMBASE, and PubMed up to March 2023. It identifies key factors influencing the nutritional status of liver transplant patients, such as pre-existing malnutrition, the type and severity of liver disease, comorbidities, and immunosuppressive medications. The review highlights the importance of pre-operative nutritional assessment and intervention, close nutritional status monitoring, individualised nutrition care plans, and ongoing nutritional support and monitoring after LT. The review concludes by examining the effect of bariatric surgery on the nutritional status of liver transplant recipients. The review offers valuable insights into the challenges and opportunities for optimising nutritional status before, during, and after LT

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

Eficacia y tolerabilidad de esteroides epidurales vs. Dosis bajas de esteroides mas metamizol mas D-propoxifeno administrados por vía paravertebral en pacientes con síndrome post-laminectomía

As the clinical applications of the central antinociceptive action of the non-steroidal antiinflammatory agents have been recognized, their combination with mild doses of opiods has been explored in order to be able to reduce or eliminate the repetitious usage of steroids. A group of 152 adult patients with recurrent radiculopathy after the first laminectomy, at either L4-L5 or L5-S1 levels, in whom periradicular fibrosis and scarring had been shown at MRI exam, was separated at random into two subgroups. Subgroup A included 69 patients that were treated with four epidural injections of 80mg of methylprednisolone (MTP) in 3ml of 0.25% bupivacaine (BPV). Changes in pain level, physical activity and the type of medications used were followed using the Pain Progress Score that evaluates five parameters graded from 0 to 2, before initiating treatment and again before each of the three subsequent injections, given at three week intervals. Subgroup B included 73 patients treated by paravertebral injections of 40mg of MTP, 50mg of dipyrone (DPN), 12.5mg of propoxyphene (PPX) and 1ml of 0.5% BPV at the L4-L5 and L5-S1 spaces, bilateral. All patients improved clinically without observing statistically significant differences between the two groups; however, there was a significant difference (p 0.05) solo cuando se compararon con las mediciones de mejoría clínica, tomadas antes de iniciar el tratamiento en ambos grupos. Se presentaron efectos secundarios como incremento de peso, equimosis, edema fascies lunar y eritema facial en los pacientes del grupo A. La punción dural incidental (3) y cefalea por punción dural (2) se encontraron solo en el grupo A. Un paciente requirió ser tratado con un parche hematico epidural. Ocurrió parestesia en 1 paciente de cada grupo. No se encontraron diferencias significativas de mejoria entre grupos de pacientes con radiculopatia post-laminectomia lumbar, al ser tratados con MTP y BPV peridural y un grupo semejante que recibio la mitad de la dosis de MTP, mas BPV, DPN y PPX, en los espacios paravertebral L4-L5 y L5-S1. Los efectos secundarios y la morbilidad predominaron en el grupo tratado con inyecciones peridurales. Inyectando fuera del canal vertebral dosis reducidas de un opiáceo y de un antiinflamatorio, permitió usar solo la mitad de la dosis total de MTP. Ya que se obtiene una mejoría semejante, al evitar los efectos indeseables de los esteroides, así como las posibles complicaciones típicas de inyecciones epidurales, hacen de esta modalidad terapéutica una alternativa definitiva

Application of cognitive remediation in the world: new experiences from two schizophrenia rehabilitation centers in Togo and Benin

PurposePeople with schizophrenia in Sub-Saharan Africa often live in very difficult conditions, suffer important social isolation and usually do not receive any kind of treatment. In this context, some non-governmental initiatives have come to light, providing accommodation, food, primary healthcare, medications and, in some cases, education and rehabilitation. The aims of this study were to assess feasibility, effects, and acceptability of a Cognitive Remediation Therapy (CRT) intervention in the particular context of psychiatric rehabilitation in Togo and Benin.MethodsPatients diagnosed with schizophrenia accessing the "Saint Camille" association rehabilitation centers in Togo and Benin during the enrollment period were allocated consecutively with a 1:1 proportion to receive a manualized CRT intervention (46 one-hour sessions over 14 weeks) or continuing Treatment As Usual (TAU). The assessment included validated measures of cognitive performance and real-world functioning and was performed at baseline and at the conclusion of treatment.ResultsAll subjects that were invited into the study agreed to participate and completed the intervention, for a total of 36 participants. CRT produced greater improvements than TAU in processing speed, working memory, verbal memory, cognitive flexibility, and executive functions measures, with moderate to large effect sizes, in particular in processing speed and working memory domains.ConclusionsCRT represents a feasible and effective psychosocial intervention that can be implemented even in contexts with very limited resources, and could represent an important instrument to promote the rehabilitation process of people living with schizophrenia in low-income countries