Healthcare utilization of elderly persons hospitalized after a noninjurious fall in a Swiss academic medical center.

OBJECTIVES: To determine the risk of hospital readmission, nursing home admission, and death, as well as health services utilization over a 6-month follow-up, in community-dwelling elderly persons hospitalized after a noninjurious fall. DESIGN: Prospective cohort study with 6-month follow-up. SETTING: Swiss academic medical center. PARTICIPANTS: Six hundred ninety persons aged 75 and older hospitalized through the emergency department. MEASUREMENTS: Data on demographics and medical, physical, social, and mental status were collected upon admission. Follow-up data were collected from the state centralized billing system (hospital and nursing home admission) and proxies (death). RESULTS: Seventy patients (10%) were hospitalized after a noninjurious fall. Fallers had shorter hospital stays (median 4 vs 8 days, P<.001) and were more frequently discharged to rehabilitation or respite care than nonfallers. During follow-up, fallers were more likely to be institutionalized (adjusted hazard ratio=1.82, 95% confidence interval=1.03-3.19, P=.04) independent of comorbidity and functional and mental status. Overall institutional costs (averaged per day of follow-up) were similar for both groups ($138.5 vs $148.7, P=.66), but fallers had lower hospital costs and significantly higher rehabilitation and long-term care costs ($55.5 vs $24.1, P<.001), even after adjustment for comorbidity, living situation, and functional and cognitive status. CONCLUSION: Elderly patients hospitalized after a noninjurious fall were twice as likely to be institutionalized as those admitted for other medical conditions and had higher intermediate and long-term care services utilization during follow-up, independent of functional and health status. These results provide direction for interventions needed to delay or prevent institutionalization and reduce subsequent costs.

Spin polarized neutron matter and magnetic susceptibility within the Brueckner-Hartree-Fock approximation

The Brueckner-Hartree-Fock formalism is applied to study spin polarized neutron matter properties. Results of the total energy per particle as a function of the spin polarization and density are presented for two modern realistic nucleon-nucleon interactions, Nijmegen II and Reid93. We find that the dependence of the energy on the spin polarization is practically parabolic in the full range of polarizations. The magnetic susceptibility of the system is computed. Our results show no indication of a ferromagnetic transition which becomes even more difficult as the density increases.

Theoretical study of elastic electron scattering off stable and exotic nuclei

Results for elastic electron scattering by nuclei, calculated with charge densities of Skyrme forces and covariant effective Lagrangians that accurately describe nuclear ground states, are compared against experiment in stable isotopes. Dirac partial-wave calculations are performed with an adapted version of the ELSEPA package. Motivated by the fact that studies of electron scattering off exotic nuclei are intended in future facilities in the commissioned GSI and RIKEN upgrades, we survey the theoretical predictions from neutron-deficient to neutron-rich isotopes in the tin and calcium isotopic chains. The charge densities of a covariant interaction that describes the low-energy electromagnetic structure of the nucleon within the Lagrangian of the theory are used to this end. The study is restricted to medium- and heavy-mass nuclei because the charge densities are computed in mean-field approach. Because the experimental analysis of scattering data commonly involves parameterized charge densities, as a surrogate exercise for the yet unexplored exotic nuclei, we fit our calculated mean-field densities with Helm model distributions. This procedure turns out to be helpful to study the neutron-number variation of the scattering observables and allows us to identify correlations of potential interest among some of these observables within the isotopic chains.

Spin-2 gravitational trace anomaly

The part proportional to the Euler-Poincar characteristic of the contribution of spin-2 fields to the gravitational trace anomaly is computed. It is seen to be of the same sign as all the lower-spin contributions, making anomaly cancellation impossible. Subtleties related to Weyl invariance, gauge independence, ghosts, and counting of degrees of freedom are pointed out.

Off-pump transapical mitral valve-in-ring implantation.

OBJECTIVES: The study aimed to evaluate the feasibility of off-pump transapical mitral valve-in-ring implantation and to test the performance of a custom-made self-expandable stent valve, in comparison with the standard SAPIEN valve. METHODS: Acute experiments were performed in five pigs. Animals (mean weight 58.4 ± 7.3 kg) underwent mitral valve annuloplasties under cardiopulmonary bypass using 26-mm rings (SJM?). Then, a 30-mm custom-made self-expandable stent valve or a 23-mm balloon-expandable transcatheter heart valve (Edwards SAPIEN XT?) was deployed within the annuloplasty rings through a transatrial access and under direct vision. Subsequently, the stent valves were inserted transapically under fluoroscopic guidance and off pump. RESULTS: The procedural success of transatrial and transapical mitral valve-in-ring procedures was 100% (10 of 10). Mean transatrial and transapical procedure time was 2.0 ± 1.1 and 22.0 ± 5.7 min, respectively. Haemodynamic status during transapical implantation remained stable, and differences in data collected before and after the stent-valve deployment were not statistically significant. Mean mitral annulus diameter and mean mitral orifice area in the group of self-expandable stent valves were 2.60 ± 0.02 cm and 4.16 ± 0.48 cm(2), respectively, whereas in the SAPIEN group they were 1.95 ± 0.18 cm and 2.26 ± 0.20 cm(2), respectively. Trace or mild regurgitation was detected only in the self-expandable stent-valve group. Mean gradients were 4.1 ± 4.5 mmHg across the self-expandable stent valves and 1.0 ± 0 mmHg across the SAPIEN valves. Postmortem examination confirmed adequate positioning of the self-expandable valves and the SAPIEN valves within the annuloplasty ring. CONCLUSIONS: Off-pump transapical mitral valve-in-ring implantation is safe and feasible. Transapical access may represent the ideal option for valve-in-ring procedures in cases of recurrent mitral regurgitation after mitral valve repair, in high-risk patients. Owing to the supra-annular profile of the valve components, our custom-made nitinol stent valve provides nearer to normal functional area than the SAPIEN valve.

The QCD Potential at O(1/m2): Complete spin-dependent and spin-independent result

Within an effective field theory framework, we obtain an expression, with O(1/m2) accuracy, for the energies of the gluonic excitations between heavy quarks, which holds beyond perturbation theory. For the singlet heavy-quarkantiquark energy, in particular, we also obtain an expression in terms of Wilson loops. This provides, twenty years after the seminal work of Eichten and Feinberg, the first complete expression for the heavy quarkonium potential up to O(1/m2) for pure gluodynamics. Several errors present in the previous literature (also in the work of Eichten and Feinberg) have been corrected. We also briefly discuss the power counting of NRQCD in the nonperturbative regime.

Classical motions from pseudoclassical spin-1/2 particle models

The classical trajectory and spin precessions of Bargmann, Michel, and Telegdi are deduced from a pseudoclassical model of a relativistic spin-(1/2) particle. The corresponding deduction from a non- relativistic model is also given.

Spin-3/2 gravitational trace anomaly

It is argued that previous computations of the spin-(3/2 anomaly have spurious contributions, as there is Weyl-invariance breaking already at the classical level. The genuine, gauge-invariant, spin-(3/2 gravitational trace anomaly is computed here.

Proton emission off nuclei induced by kaons in flight

We study the (K-, p) reaction on nuclei with a 1 GeV/c momentum kaon beam, paying special attention to the region of emitted protons having kinetic energy above 600 MeV, which was used to claim a deeply attractive kaon nucleus optical potential. Our model describes the nuclear reaction in the framework of a local density approach and the calculations are performed following two different procedures: one is based on a many-body method using the Lindhard function and the other is based on a Monte Carlo simulation. The simulation method offers flexibility to account for processes other than kaon quasielastic scattering, such as K- absorption by one and two nucleons, producing hyperons, and allows consideration of final-state interactions of the K-, the p, and all other primary and secondary particles on their way out of the nucleus, as well as the weak decay of the produced hyperons into pi N. We find a limited sensitivity of the cross section to the strength of the kaon optical potential. We also show a serious drawback in the experimental setup-the requirement for having, together with the energetic proton, at least one charged particle detected in the decay counter surrounding the target-as we find that the shape of the original cross section is appreciably distorted, to the point of invalidating the claims made in the experimental paper on the strength of the kaon nucleus optical.

Off-axis vortices in trapped Bose-condensed gases: Angular momentum and frequency splitting

We consider noncentered vortices and their arrays in a cylindrically trapped Bose-Einstein condensate at zero temperature. We study the kinetic energy and the angular momentum per particle in the Thomas-Fermi regime and their dependence on the distance of the vortices from the center of the trap. Using a perturbative approach with respect to the velocity field of the vortices, we calculate, to first order, the frequency shift of the collective low-lying excitations due to the presence of an off-center vortex or a vortex array, and compare these results with predictions that would be obtained by the application of a simple sum-rule approach, previously found to be very successful for centered vortices. It turns out that the simple sum-rule approach fails for off-centered vortices.

Dynamics of the two-dimensional gonihedric spin model

In this paper, we study dynamical aspects of the two-dimensional (2D) gonihedric spin model using both numerical and analytical methods. This spin model has vanishing microscopic surface tension and it actually describes an ensemble of loops living on a 2D surface. The self-avoidance of loops is parametrized by a parameter ¿. The ¿=0 model can be mapped to one of the six-vertex models discussed by Baxter, and it does not have critical behavior. We have found that allowing for ¿¿0 does not lead to critical behavior either. Finite-size effects are rather severe, and in order to understand these effects, a finite-volume calculation for non-self-avoiding loops is presented. This model, like his 3D counterpart, exhibits very slow dynamics, but a careful analysis of dynamical observables reveals nonglassy evolution (unlike its 3D counterpart). We find, also in this ¿=0 case, the law that governs the long-time, low-temperature evolution of the system, through a dual description in terms of defects. A power, rather than logarithmic, law for the approach to equilibrium has been found.

Renal arteries: navigator-gated balanced fast field-echo projection MR angiography with aortic spin labeling: initial experience.

A cardiac-triggered free-breathing three-dimensional balanced fast field-echo projection magnetic resonance (MR) angiographic sequence with a two-dimensional pencil-beam aortic labeling pulse was developed for the renal arteries. For data acquisition during free breathing in eight healthy adults and seven consecutive patients with renal artery disease, real-time navigator technology was implemented. This technique allows high-spatial-resolution and high-contrast renal MR angiography and visualization of renal artery stenosis without exogenous contrast agent or breath hold. Initial promising results warrant larger clinical studies.

Collective spin excitations of alkali-metal clusters

The response function of alkali-metal clusters, modeled as jellium spheres, to dipole (L=1) and quadrupole (L=2) spin-dependent fields is obtained within the time-dependent local-spin-density approximation of density-functional theory. We predict the existence of low-energy spin modes of surface type, which are identified from the strength function. Their collectivity and evolution with size are discussed.