Nursing home food services linked with risk of malnutrition.

PURPOSE: Links between food service characteristics and residents' risk of malnutrition were examined. METHODS: Cognitively intact residents meeting inclusion criteria and living in one of 38 participating nursing homes were randomly sampled. The final sample consisted of 132 residents, who were screened for risk of malnutrition and completed a face-to-face interview questionnaire about dining experiences. Additional data came from participants' medical charts, and each institution's food service manager completed a written questionnaire. Frequencies and logistic regressions were used to describe the sample and to examine relationships between risk of malnutrition and food service characteristics. RESULTS: Overall, 37.4% of participants were at risk of malnutrition. Food service factors, including food packages, lids, and dishes that were difficult to manipulate (b=0.285, p=0.009), bulk food-delivery systems (b=1.329, p=0.036), overall food satisfaction (b=0.253, p=0.044), menu cycle length (b=-2.162, p=0.003), and porcelain dishes (b=-0.345, p=0.052), all were significantly associated with risk of malnutrition. CONCLUSIONS: Our findings clearly show a need for nursing homes to modify certain aspects of food service that may increase the risk of malnutrition among cognitively intact residents.     

Clinical trial of retrograde warm blood reperfusion versus standard cold topical irrigation of transplanted hearts

BACKGROUND: A prospective, randomized clinical study involving 34 patients undergoing heart transplantation compared myocardial preservation of donor hearts maintained with continuous reperfusion with retrograde warm blood cardioplegia during surgical implantation versus the standard cold topical irrigation. METHODS: Hearts in both groups were arrested with a standard crystalloid solution and maintained in a cold saline solution during transportation. In the retrograde group, cardioplegia was administered through a catheter in the coronary sinus during surgical implantation. An average of 471 +/- 30 mL of hyperkalemic crystalloid solution diluted 1:4 in warm blood from the oxygenator was infused. In the standard group, the heart was kept cold by topical irrigation of cold saline solution and was reperfused only when the ascending aorta was unclamped. RESULTS: Preoperative characteristics of donors and recipients were similar in the two cohorts. Ischemic time average 139 +/- 12 minutes in the retrograde group compared with 130 +/- 11 minutes in the standard group (p = 0.57). Cardiopulmonary bypass time averaged 89 +/- 4 minutes in the retrograde group and 110 +/- 12 minutes in the standard group (p = 0.12). Defibrillation at reperfusion was performed in 4 patients (4/17, 24%) in the retrograde group and 12 patients (12/18, 67%) in the standard group (p = 0.01). There were no deaths in the retrograde group (0/17), whereas in the standard group, 3 patients (3/17) died of early graft failure (p = 0.11). Four early graft failures occurred in the standard group (p = 0.06). Two patients (2/17, 12%) were weaned from bypass with ventricular assist devices in the standard group. The number of subendocardial necrotic cells in the first two weekly endomyocardial biopsy specimens averaged 2.7 +/- 0.8 cells/mm2 in the retrograde group and 5.9 +/- 2.4 cells/mm2 in the standard group (p = 0.12). CONCLUSIONS: Retrograde warm blood reperfusion appears to improve the initial recovery of transplanted hearts. The technique is easy to use and may be a useful approach to graft protection during surgical implantation.     

焊接过程微机控制系统中线性隔离电路的研究

本文以MOC5010为基础元件,根据焊接过程微机控制系统的特点,设计了用于电流电压检测及数字控制回路中的线性光电耦合电路,实验结果及实际应用证明:该电路良好地达到了预期的目的。     

Application of a glyphosate-based herbicide to Phragmites australis: Impact on groundwater and near-shore lake water at a beach on Georgian Bay

During the past decade, the invasive Phragmites australis (common reed) has established itself along beaches of the Great Lakes, causing detrimental impacts to both the natural ecological integrity of the shoreline and the recreational value of beaches. The herbicide Roundup®, containing the active ingredient glyphosate, was applied to Phragmites along a beach on the southern shore of Georgian Bay, Canada, to eradicate the Phragmites which was destroying the natural beach ecosystem. Groundwater and lake water were tested to determine if glyphosate enters the groundwater and lake at the beach and how long glyphosate will persist. Two days after application, the geometric mean concentration of glyphosate in the groundwater below the Phragmites was 0.060 μg/L with a maximum of 12.50 μg/L. Concentrations rapidly declined over the next two to three weeks to below minimum detection limits (< 0.020 μg/L). Glyphosate was also detected in the nearshore lake water with concentrations peaking at a geometric mean of 0.14 μg/L one week after application, and declining to 0.039 μg/L four weeks after application. Concentrations of glyphosate never exceeded the Canadian water quality guideline for the protection of aquatic life (65 μg/L) in either the groundwater or lake water. An approximate half-life for the dissipation of glyphosate by degradation and dilution/flushing as groundwater flows toward the lake, assuming a first order kinetic reaction, yielded a half-life of 3.5 during the 4 weeks after the herbicide was applied. The application of Roundup® resulted in an 90% reduction in the size of the stand of Phragmites.     

Perceiving interpersonally-mediated risk in virtual environments

Using virtual reality (VR) to examine risky behavior that is mediated by interpersonal contact, such as agreeing to have sex, drink, or smoke with someone, offers particular promise and challenges. Social contextual stimuli that might trigger impulsive responses can be carefully controlled in virtual environments (VE), and yet manipulations of risk might be implausible to participants if they do not feel sufficiently immersed in the environment. The current study examined whether individuals can display adequate evidence of presence in a VE that involved potential interpersonally-induced risk: meeting a potential dating partner. Results offered some evidence for the potential of VR for the study of such interpersonal risk situations. Participants’ reaction to the scenario and risk-associated responses to the situation suggested that the embodied nature of virtual reality override the reality of the risk’s impossibility, allowing participants to experience adequate situational embedding, or presence.     

AutoTutor: Incorporating Back-Channel Feedback and Other Human-Like Conversational Behaviors into an Intelligent Tutoring System

This paper describes our recent attempts to incorporate human-like conversational behaviors into the dialog moves delivered by an animated pedagogical agent that simulates human tutors. We first present a brief overview of the modules comprising AutoTutor, an intelligent tutoring system. The second section describes a set of conversational behaviors that are being incorporated into AutoTutor. The behaviors of interest involve variations in intonation, head movements, arm and hand movements, facial expressions, eye blinking, gaze direction, and back-channel feedback. The final section presents a recent empirical study concerned with back-channel feedback events during human-to-human tutoring sessions. The back-channel feedback events emitted by tutors are mostly positive (63%), mostly verbal (77%), and immediately follow speech-act boundaries or noun-phrase boundaries (83%). Tutors also deliver back-channelevents at a very high rate when students are emitting dialog, about 13 events per minute. Conversely, 88% of students' back-channel feedback events are head nods, and they occur at unbounded locations (63%).     

Visual lobe shape and search performance for targets of different difficulty

In quantitative models of visual search it has usually been assumed that visual lobe area shape was sufficiently regular to be approximated by a circle or ellipse. However, the irregularities in visual lobe shapes that have been found in studies involving extensive lobe mapping have suggested that lobe shape may have important implications for visual search performance and for the accuracy of mathematical models used for performance prediction. However, no systematic research on the relationship between the shape aspect of visual lobes and search performance seems to have been carried out and no comparisons of visual lobe shape characteristics under the effect of target difficulty have been reported. The current study was conducted to achieve two major objectives in two experiments. Experiment 1 used two different targets (letter 'O' and letter 'Y') to map the visual lobes of subjects in order to provide a systematic and quantitative comparison of lobe shape characteristics and experiment 2 was to investigate the correlation of visual lobe shape characteristics with visual search time under the effect of target difficulty. The visual lobes of 28 subjects were mapped on 24 imaginary and regularly spaced meridians originating from the centre of the visual field to resemble the full field mapping situation. Five categories of shape indices, viz. roundness, boundary smoothness, symmetry, elongation and shape regularity were investigated. The results of this study demonstrated that the visual lobe shapes of subjects elongate horizontally with medium level of roundness, high levels of boundary smoothness, symmetry and regularity for an easy target (O) against a homogeneous background of 'X's. When a difficult target (Y) was used, the visual lobes of the subjects were still elongated horizontally but to a smaller extent and with a low level of roundness, medium level of boundary smoothness and regularity and a similar high level of symmetry to the easy target. Moreover, significant correlations between shape indices and visual search time were found, suggesting mathematical models for predicting search time should not merely rely on area but also should consider visual lobe shape indices. Finally, a universal mathematical model containing several visual lobe shape indices was developed, which was applicable in the prediction of visual search time for a range of similar search tasks.