Integrated care at home reduces unnecessary hospitalizations of community-dwelling frail older adults: a prospective controlled trial.

Care of frail and dependent older adults with multiple chronic conditions is a major challenge for health care systems. The study objective was to test the efficacy of providing integrated care at home to reduce unnecessary hospitalizations, emergency room visits, institutionalization, and mortality in community dwelling frail and dependent older adults. A prospective controlled trial was conducted, in real-life clinical practice settings, in a suburban region in Geneva, Switzerland, served by two home visiting nursing service centers. Three hundred and one community-dwelling frail and dependent people over 60 years old were allocated to previously randomized nursing teams into Control (N = 179) and Intervention (N = 122) groups: Controls received usual care by their primary care physician and home visiting nursing services, the Intervention group received an additional home evaluation by a community geriatrics unit with access to a call service and coordinated follow-up. Recruitment began in July 2009, goals were obtained in July 2012, and outcomes assessed until December 2012. Length of follow-up ranged from 5 to 41 months (mean 16.3). Primary outcome measure was the number of hospitalizations. Secondary outcomes were reasons for hospitalizations, the number and reason of emergency room visits, institutionalization, death, and place of death. The number of hospitalizations did not differ between groups however, the intervention led to lower cumulative incidence for the first hospitalization after the first year of follow-up (69.8%, CI 59.9 to 79.6 versus 87 · 6%, CI 78 · 2 to 97 · 0; p = .01). Secondary outcomes showed that the intervention compared to the control group had less frequent unnecessary hospitalizations (4.1% versus 11.7%, p = .03), lower cumulative incidence for the first emergency room visit, 8.3%, CI 2.6 to 13.9 versus 23.2%, CI 13.1 to 33.3; p = .01), and death occurred more frequently at home (44.4 versus 14.7%; p = .04). No significant differences were found for institutionalization and mortality. Integrated care that included a home visiting multidisciplinary geriatric team significantly reduced unnecessary hospitalizations, emergency room visits and allowed more patients to die at home. It is an effective tool to improve coordination and access to care for frail and dependent older adults. Clinical Trials.gov Identifier: NCT02084108 . Retrospectively registered on March 10(th) 2014

Novel antennae for the sensitization of near infrared luminescent lanthanide cations

International audienceNear Infrared (NIR) luminescence is useful for many applications ranging from lasers, telecommunication to biological imaging We have a special interest for applications in biological media since NIR photons have less interference with such samples. NIR photons can penetrate relatively deeply in tissues and cause less damage to biological samples. The use of NIR luminescence also results in improved detection sensitivity due to low background emission. The lower scattering of NIR photons results in improved image resolution. NIR emitting lanthanide compounds are promising for imaging because of their unique properties such as sharp emission bands, long luminescence lifetimes and photostability Here, we review our efforts to develop novel sensitizers for NIR emitting lanthanides We have employed two global strategies (1) monometallic lanthanide complexes based on derivatives of salophen, tropolonate, azulene and pyridine, and (2) polymetallic lanthanide compounds based on nanocrystals, metal-organic frameworks and dendrimers complexes

Metal induced folding: Synthesis and conformational analysis of the lanthanide complexes of two 44-membered hydrazone macrocycles

Six new lanthanide complexes of two 44-membered macrocycles have been prepared and characterised in solution. An analysis of the conformations of the free macrocycles and their lanthanide complexes both in solution (2D NMR) and in solid state (X-ray crystallography) demonstrate that the complexation induces changes in folding of the macrocycles

A Unique LnIII{[3.3.1]GaIII Metallacryptate} Series That Possesses Properties of Slow Magnetic Relaxation and Visible/Near‐Infrared Luminescence

A new family of [3.3.1] metallacryptates with the general composition [LnGa6(H2shi)(Hshi)(shi)7(C5H5N)] (Ln‐1; shi3−=salicylhydroximate; Ln = Pr, Nd, Sm–Yb) has been synthesized and characterized. Ln‐1 display both interesting magnetic and luminescent properties. Sm‐1 has sharp emission bands in the visible and the near‐infrared (NIR) regions with quantum yield values (QSmL) of 1.64(9) and 5.5(2).10−2 %, respectively. Tb‐1 exhibits a weak green emission (QTbL=1.89(3).10−1 %) while Pr‐1, Nd‐1, Ho‐1, Er‐1, and Yb‐1 possess emission bands in the NIR range with QPrL=3.7(2).10−3 %, QNdL=1.71(5).10−1 %, QHoL=1.1(2).10−3 %, QErL=7.1(2).10−3 % and QYbL=0.65(3) %. Nd‐1, Dy‐1, and Yb‐1 display slow magnetization relaxation in an applied field, where only Dy‐1 has been observed to follow an Orbach process (Ueff=12.7 K). The combination of NIR emission with magnetic properties makes Nd‐1 and Yb‐1 attractive candidates as smart materials addressable in two manners.A two‐for‐one scaffold: A new LnIII‐encapsulating metallamacrocyclic scaffold was synthesized and structurally determined to resemble cryptands. This metallacryptand can bind a wide variety of LnIII ions of different natures and demonstrates the ability to sensitize their characteristic emissions in the visible and/or near‐infrared. Slow magnetic relaxation was also observed for selected LnIII.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145255/1/chem201801355.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145255/2/chem201801355_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145255/3/chem201801355-sup-0001-misc_information.pd

Innovative Multipodal Ligands Derived from Tröger's Bases for the Sensitization of Lanthanide(III) Luminescence

Herein, the synthesis and characterization of the first family of multipodal ligands with a Tröger's base framework designed for the preparation of luminescent lanthanide(III) complexes are reported. Eight ligands were designed and synthesized using different strategies, including alkylation reactions, amide couplings, and Ugi multicomponent reactions. All the ligands bear carboxylate groups for the coordination of the lanthanide(III) ions, with the lanthanide(III)-sensitizing units consisting of the Tröger's base framework itself or attached benzamides. Upon irradiation of the chromophoric ligands, green terbium(III) emission was efficiently generated, whereas europium(III) emission was negligible. The geometry and substitution pattern of the ligands allow control of the stoichiometry of the species formed and the TbIII luminescence sensitization efficiency, showing that para-substitution patterns are more efficient than meta substitution for the formation of coordination compounds with lower TbIII/ligand ratio. We propose that the species formed are self-assembled 2:2 or 2:4 metallosupramolecular structures.Fil: Trupp, Leandro Julián. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química, Física de los Materiales, Medioambiente y Energía. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química, Física de los Materiales, Medioambiente y Energía; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Unidad de Microanálisis y Métodos Físicos en Química Orgánica. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Unidad de Microanálisis y Métodos Físicos en Química Orgánica; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Orgánica; Argentina. Centre National de la Recherche Scientifique; FranciaFil: Bruttomesso, Andrea. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Orgánica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Unidad de Microanálisis y Métodos Físicos en Química Orgánica. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Unidad de Microanálisis y Métodos Físicos en Química Orgánica; ArgentinaFil: Varde, Mariana. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Orgánica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Unidad de Microanálisis y Métodos Físicos en Química Orgánica. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Unidad de Microanálisis y Métodos Físicos en Química Orgánica; ArgentinaFil: Eliseeva, Svetlana. Centre National de la Recherche Scientifique; FranciaFil: Ramirez, Javier Alberto. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Orgánica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Unidad de Microanálisis y Métodos Físicos en Química Orgánica. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Unidad de Microanálisis y Métodos Físicos en Química Orgánica; ArgentinaFil: Petoud, Stephane. Centre National de la Recherche Scientifique; FranciaFil: Barja, Beatriz Carmen. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química, Física de los Materiales, Medioambiente y Energía. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química, Física de los Materiales, Medioambiente y Energía; Argentin

Unravelling the mechanism of water sensing by the Mg2+ dihydroxy-terephthalate MOF (AEMOF-1 ‘)

In this contribution we build upon our previous work on the MOF [Mg(H(2)dhtp)(H2O)(2)]center dot DMAc (AEMOF-1 center dot DMAc) and its activated dry version AEMOF-1 ‘ which has been shown to exhibit excellent luminescence sensing properties towards water in organic solvents. We demonstrate through combined structural and photophysical studies that the observed changes in the fluorescence properties of AEMOF-1 ‘ upon hydration arise from a structural transformation to the mononuclear complex [Mg(H(2)dhtp)(H2O)(5)]center dot H2O (H(4)dhtp = 2,5-dihydroxyterepthalic acid) (1). In the latter complex, excited state intramolecular proton transfer (ESIPT) is strongly favoured thereby leading to enhanced and red shifted emission in comparison to AEMOF-1 center dot DMAc. Powder X-ray diffraction measurements confirmed that complex 1 is identical to the hydrated form of AEMOF-1 center dot DMAc. As in the case of AEMOF-1 ‘, the dry form of complex 1 (1 ‘) is also an effective sensor for the determination of traces of water in tetrahydrofuran (THF). This work demonstrates that the same chromophore may exhibit very different emission properties when it exists in different chemical environments and that these transformations may be controlled and utilized in water sensing applications