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

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

SiC MOSFETs capacitance study

SiC MOSFTEs are widely used nowadays for a large number of power applications. Even though they are more performant than their Silicon counterpart, they suffer from some issues which are still unsolved. Among these, the high traps concentration existing at the SiC/SiO2 interface is one of the main concerns while evaluating the device performance. To this aim, the characterization of such interface is of paramount importance. Capacitance versus voltage (C–V) curves are fast and non-destructive measurements which can give an insight in the device physics. They are usually performed with the driving signal imposed on the Gate, while Drain and Source are grounded. However, measuring the capacitance in alternative configuration can provide additional information about the traps distribution existing in the mentioned interface. In this work, a numerical study is performed on the capacitance measured in the following configurations: (i) floating Source; (ii) floating Drain and (iii) positive biased Drain. The study has been performed at different temperature. The numerical results are enforced by experimental findings

Experimental Analysis of C-V and I-V Curves Hysteresis in SiC MOSFETs

SiC MOSFETs have already replace silicon-based device in power applications, even if some technological issues are still not solved. The most important of them is related to the complex traps distribution at SiC/SiO2 interface. Interface traps affect the overall device behavior, modifying channel mobility and introducing hysteresis. In this work experimental C-V and I-V curves are carried out on various commercial SiC MOSFET at different temperatures. The focus is the comparison of hysteresis arising in trench and planar SiC MOSFETs

TCAD model calibration for the SiC/SiO2interface trap distribution of a planar SiC MOSFET

Silicon carbide (SiC) metal-oxide-semiconductor field effect transistor (MOSFETs) are gradually replacing silicon power devices in many applications because of the higher performances of the material. Even if the technology for SiC MOSFET has been improved in the last years, the very high interface SiO2/SiC trap density is still a problem that affects the present SiC MOSFET generations. This issue is still not addressed in technology computer aided design (TCAD) simulations supporting the devices development. In this work we demonstrate how an accurate calibration of the TCAD model of a commercial SiC MOSFET is only possible by considering a non-uniform trap distribution along the SiO2 SiC interface

SiC MOSFET C-V Curves Analysis with Floating Drain Configuration

SiC MOSFETs have already replaced silicon-based device in power applications, even if some technological issues are still not solved. Among others, the complex traps distribution at SiC/SiO2 interface is of foremost importance. Interface traps affect the overall device behavior, modifying channel mobility and introducing hysteresis. In this work, the capacitance behavior, when the Drain terminal is floating, is studied through numerical analysis. The effects of traps distribution and its properties on such curves has been studied along with temperature effects. Experimental curves are carried out at various temperatures and compared to the same trends of numerical results

Reversible posterior leukoencephalopathy syndrome in 2 HIV-infected patients receiving antiretroviral therapy

We describe 2 human immunodeficiency virus-infected patients who developed hypertension and severe neurological abnormalities while receiving successful antiretroviral therapy. Neuroimaging findings were characteristic of reversible posterior leukoencephalopathy syndrome, a brain-capillary leak syndrome with hypertension and endothelial damage. We discuss the role of antiretroviral therapy-associated metabolic alterations in endothelial damage, hypertension, and reversible posterior leukoencephalopathy syndrome

SiC/SiO2interface traps effect on SiC MOSFETs Gate capacitance with biased Drain

In this paper the effects of SiC/SiO2 interface traps on SiC MOSFETs Gate Capacitance are investigated when a positive bias is applied at the Drain terminal. The Gate capacitance arising from this configuration shows an unexpected sharp peak, exceeding the oxide capacitance, for a Gate voltage close to the threshold voltage. The properties of such peak are studied through numerical analysis. Results affirm that the peak is related to the displacement current, and its origin lies in the channel region. The so-measured Gate capacitance can allow the extraction of important interface properties, such as traps concentration at the SiC/SiO2 interface. Also the effects of temperature on this peak are investigated through experimental and numerical analysi