Longitudinal weight changes, length of survival, and energy requirements of long-term care residents with dementia

OBJECTIVE: We hypothesized that institutionalized patients with dementia, who frequently have feeding problems and require supervised and assisted feeding, would lose more weight during their residency than nondemented, independently functioning residents and have compromised survival. To test this hypothesis, we examined the survival and longitudinal changes in weight of two cohorts of institutionalized residents with dementia and compared these cohorts with a cohort of nondemented residents. We also measured the resting energy expenditures of a subset of the subjects with dementia as an indicator of their energy needs. DESIGN: A longitudinal cohort study with retrospective baseline chart review and subsequent follow-up of monthly weights and mortality over 4 years. SETTING: A 725-bed long-term care institution with specified levels of care. SUBJECTS: Two cohorts of residents with dementia, one consisting of subjects who required total care throughout their institutional stay (n = 31) and another group who did not initially require total care (n = 48); these were compared with a cohort with normal mentation who were functionally independent in their daily activities (n = 26). The total number of subjects was 105. MEASUREMENTS: Demographics, medical problems, and medications by chart review; functional and mental status evaluations; longitudinal monthly weights and mortality for the 48-month study period; and resting energy expenditures by indirect calorimetry. MAIN RESULTS: Residents with dementia had lower weights on admission and throughout their stay than nondemented, independently functioning residents, and they were more likely to have a weight loss of 10 lbs or more at some point during the 4-year study period. However, their mean weights did not change during the study period. The mean survival from admission of those demented residents who died was more than 3 years. Resting energy expenditures of women residents with advanced dementia were 12% lower than predicted from the Harris Benedict equations. CONCLUSION: Dementia is not necessarily associated with unremitting weight loss during institutionalization despite the frequent occurrence of feeding difficulties and temporary weight loss. This may be caused partly by the lower than expected resting energy expenditures and, hence, energy needs of affected residents as their dementia progresses. Demented residents weighed significantly less than nondemented, independently functioning residents throughout their institutional stay. Nevertheless, nursing staff are able to maintain weight and survival for extended periods even in very impaired residents.     

Measurements and correlation of effect of cosolvents on the solubilities of complex molecules in supercritical carbon dioxide

A new transparent microscale circulation-type high pressure equilibrium cell with on-line sampling was devised. With this apparatus, experimental solubility of molecularly complex species such as steroids (cholesterol, stigmasterol and ergosterol) and fatty acids (palmitic acid and stearic acid) in supercritical carbon dioxide(sc-C0₂) were measured. Also, to find an appropriate substance for enhancing both the polarity and the solubility power of the SC-CO₂ solvent, we arbitrarily selected three polar substances such as acetone, methanol and water and the effect of these cosolvents on the solubility of solutes in SC-CO₂ are examined. The supercritical phase equilibrium data of solute-cosolvent-sc-CO₂ systems were quantitatively correlated using a new equation of state based on the lattice fluid theory incorporated with the concept of multibody interaction. We found that the addition of tracer amount of acetone or methanol to SC-CO₂ enhances the solubility of all solutes about thirty to sixty times when compared with the case of pure sc-CO₂ However, for the case of cosolvent water, no further enhancement of the solubility of solutes was realized. Also, the versatile fittability of the equation of state proposed in this work was demonstrated with the newly measured ternary supercritical equilibrium data.     

NO emission characteristics in counterflow diffusion flame of blended fuel of H2/CO2/Ar

Flame structure and NO emission characteristics in counterflow diffusion flame of blended fuel of H₂/CO₂/Ar have been numerically simulated with detailed chemistry. The combination of H₂, CO₂ and Ar as fuel is selected to clearly display the contribution of hydrocarbon products to flame structure and NO emission characteristics due to the breakdown of CO₂. A radiative heat loss term is involved to correctly describe the flame dynamics especially at low strain rates. The detailed chemistry adopts the reaction mechanism of GRI 2.11, which consists of 49 species and 279 elementary reactions. All mechanisms including thermal, NO₂, N₂O and Fenimore are taken into account to separately evaluate the effects of CO₂ addition on NO emission characteristics. The increase of added CO₂ quantity causes flame temperature to fall since at high strain rates a diluent effect is prevailing and at low strain rates the breakdown of CO₂ produces relatively populous hydrocarbon products and thus the existence of hydrocarbon products inhibits chain branching. It is also found that the contribution of NO production by N₂O and NO₂ mechanisms are negligible and that thermal mechanism is concentrated on only the reaction zone. As strain rate and CO₂ quantity increase, NO production is remarkably augmented. Copyright © 2002 John Wiley & Sons, Ltd.     

An EM‐based adaptive multiple target tracking filter

Tracking targets of interest is one of the major research areas in radar surveillance systems. We formulate the problem as incomplete data estimation and apply EM to the MAP estimate. The resulting filter has a recursive structure analogous to the Kalman filter. The advantage is that the measurement‐update deals with multiple measurements in parallel and the parameter‐update estimates the system parameters on the fly. Experiments tracking separate targets in parallel show that tracking maintenance ratio of the proposed system is better than that of NNF and RMS position error is smaller than that of PDAF. Also, the system parameters are correctly obtained even from incorrect initial values. Copyright © 2001 John Wiley & Sons, Ltd.     

Properties of nanoporous organosilicate hybrid thin films with a bimodal pore size distribution

Low dielectric poly[methylsilsesquioxane‐ran‐trifluoropropylsilsesquioxane‐ran‐(2,4,6,8‐tetramethyl‐2,4,6,8‐tetraethylenecyclotetrasiloxane)silsesquioxane]s {P[M‐ran‐TFP‐ran‐(TCS)]SSQs} having various compositions were synthesized using trifluoropropyl trimethoxysilane, methyl trimethoxysilane and 2,4,6,8‐tetramethyl‐2,4,6,8‐tetra(trimethoxysilylethyl)cyclotetrasiloxane. The chemical composition of the polymers and the content of SiOH end‐groups were controlled by adjusting the reaction conditions, and they were characterized by ¹H‐NMR. The thermally decomposable trifluoropropyl groups on the P[M‐ran‐TFP‐ran‐(TCS)]SSQ backbone and heptakis(2,3,6‐tri‐O‐methyl)‐β‐cyclodextrin (CD) were employed as pore generators. The dielectric constants of the porous CD/P[M‐ran‐TFP‐ran‐(TCS)]SSQ films were in the range 2.0–2.7 (at 100 kHz) depending on the concentration of the porogens, and showed no change over 4 days under aqueous conditions. The pore size of the films showed a bimodal distribution, with diameters of ca 0.5–1.0 nm for those originating from the trifluoropropyl groups and 1.7 nm from the CD. The elastic modulus and hardness of the 30 vol% CD‐blended film with a dielectric constant of 2.26 were 2.40 and 0.38 GPa, respectively, as determined by a nanoindenter. Copyright © 2005 Society of Chemical Industry     

Slow eroding biodegradable multiblock poloxamer copolymers

Biodegradable multiblock poloxamers (BMPs) with gel duration of 8 h to several weeks were prepared by varying their molecular weights from 4000 to 40 000 g mol^?1. The molecular weight of the BMP was controlled by changing the poloxamer to coupling agent ratio. Assuming a micelle packing model of the BMP gel, as in the case of a poloxamer gel, the micelle properties and critical gel concentration of BMPs were investigated on the basis of the scaling concept. The findings suggest that the control of molecular weight by hydrolyzable groups can be a facile approach to optimize the gel properties for biomedical applications. Copyright © 2005 Society of Chemical Industry     

Synthesis and characterization of an interpenetrating polymer network composed of poly(methacrylic acid) and poly(vinyl alcohol)

Temperature and pH‐responsive interpenetrating polymer network (IPN) hydrogels, constructed with poly(methacrylic acid) (PMAA) and poly(vinyl alcohol) (PVA), by a sequential IPN method, were studied. The characterization of IPN hydrogels was investigated by Fourier‐transform infrared spectroscopy, differential scanning calorimetry (DSC) and swelling under various conditions. The IPN hydrogels exhibited relatively high swelling ratios, in the range 230–380 %, at 25 °C. The swelling ratios of the PMAA/PVA IPN hydrogels were pH and temperature dependent. DSC was used for the quantitative determination of the amounts of freezing and non‐freezing water. The amount of free water increased with increasing PMAA content in the IPN hydrogels. Copyright © 2004 Society of Chemical Industry     

A single-chip storage LSI for home networks

Network direct attached storage (NDAS) is a network storage architecture that allows direct attachment of existing ATA/ATAPI devices to Ethernet without a separate server. Unlike other architectures such as NAS, SAN, and USB mass storage, no server computer intervenes between the storage and the client hosts. We describe an NDAS disk controller (NDC) amenable to low-cost single-chip implementation that processes a simplified L3/L4 protocol and converts commands between ATA/ATAPI and Ethernet, while the remaining complex tasks are performed by remote hosts. Unlike NAS architectures that use TCP/IP, NDAS uses a TCP-like lean protocol that lends itself well to high-performance hardware realization. Thanks to the simple NDAS architecture and protocol, an NDC implemented on a single 4 mm /spl times/ 4 mm chip in 0.18 /spl mu/m CMOS technology achieves a maximum throughput of 55 Mbytes/s on gigabit Ethernet, which is comparable to that of a high-performance disk locally attached to a host computer.     

High performance biofilm process for treating wastewater discharged from coal refining plants containing nitrogen, cyanide and thiocyanate.

Wastewater discharge from coal refining plants contains a number of biologically toxic compounds; 2000-2500 mg/l of COD of which 40% is composed of phenol, 100-400 mg/l of thiocyanate, 10-40 mg/l of cyanide, 100-250 mg/l of NH4+-N and 150-300 mg/l of total nitrogen. In order to treat this kind of high strength wastewater, we have developed a high performance biofilm process using fluidizing bio-carriers of the tube chip type. The fluidizing biofilm carriers are made of a composite of polyethylene and several inorganic materials, whose density is controlled at 0.97-0.98 g/ml. The fluidizing biofilm carriers show sound fluidization characteristics inside bioreactors. The wastewater is treated using three consecutive series reactors in oxic-anoxic-oxic arrangement. Each reactor is charged with the fluidizing biofilm carriers of 50 vol%. Furthermore, newly cultured active microorganisms for the thiocyanate biodegradation are added in the biofilm process. At total hydraulic retention time of 2.2 days, this process can achieve steady state removal efficiencies: COD, 99%; thiocyanate, 99%; NH4+-N, 99% and total nitrogen, 90%.