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.     

Development of co-continuous structure in liquid crystalline polyester

We investigated liquid crystallization of liquid crystalline polyester BB-5 during isothermal annealing by digital high-fidelity microscope and light scattering. A liquid crystalline spherical domain having a radius of micrometers appeared by annealing at around 180 °C. The domain grew dendritically in all directions. Neighboring liquid crystalline regions coalesced and then interconnected. The interconnected structure changed to a co-continuous two-phase structure with increasing ordering of the liquid crystalline phase, and the interface between the liquid crystalline phase and the isotropic phase became smoother over time. Liquid crystallization stopped before volume filling the whole space, and the liquid crystalline phase and isotropic phase coexisted. The liquid crystalline region became narrower with an increase in the temperature of the liquid crystallization. Such structural development is different from the liquid-liquid phase separation via spinodal decomposition, and it may be attributed to the segregation of non-liquid crystallizable low molecular weight molecules from the growth front by fractionation of the molecular weight distribution during the liquid crystallization in terms of the instability of the diffusion-controlled interface.     

An expert system for XPLE cable deterioration diagnosis and life forecasting

The recent increase in the demand for power in urban areas has caused changes in the way power is supplied. Underground distribution systems have been introduced for convenience in urban areas and to prevent injuries in case of a crisis. As a result, many new types of power cables are being used. One type, XPLE cables (also called CV cables) have been rapidly taking the place of conventional cables such as OF or SL cables since the 1960s because of their relatively easy installation and maintainability. However, distribution cables used under severe environmental conditions deteriorate rapidly (due mainly to water treeing), and some cables experience insulation breakdown. Therefore, many diagnostic methods have been developed, though they have not been very effective. By combining methods, a high reliability can be achieved in comparison to the use of a single method. However, processing the data is difficult for on-site personnel, so many experts are required. But there is a lack of qualified experts, hence we have turned to the development of expert systems.     

Fabrication of blue-light emission fused-silica substrates by using Si-ion implantation and high-temperature annealing

We fabricated fused-silica substrates which emit blue light by using Si-ion implantation and high-temperature annealing. Photoluminescence peak wavelengths are around 400 nm, and the peak intensities can be remarkable after annealing above 1150 °C.     

Induction of Tertiary Phase Epileptiform Discharges after Postasphyxial Infusion of a Toll-Like Receptor 7 Agonist in Preterm Fetal Sheep

Background: Toll-like receptor (TLR) agonists are key immunomodulatory factors that can markedly ameliorate or exacerbate hypoxic–ischemic brain injury. We recently demonstrated that central infusion of the TLR7 agonist Gardiquimod (GDQ) following asphyxia was highly neuroprotective after 3 days but not 7 days of recovery. We hypothesize that this apparent transient neuroprotection is associated with modulation of seizure-genic processes and hemodynamic control. Methods: Fetuses received sham asphyxia or asphyxia induced by umbilical cord occlusion (20.9 ± 0.5 min) and were monitored continuously for 7 days. GDQ 3.34 mg or vehicle were infused intracerebroventricularly from 1 to 4 h after asphyxia. Results: GDQ infusion was associated with sustained moderate hypertension that resolved after 72 h recovery. Electrophysiologically, GDQ infusion was associated with reduced number and burden of postasphyxial seizures in the first 18 h of recovery (p < 0.05). Subsequently, GDQ was associated with induction of slow rhythmic epileptiform discharges (EDs) from 72 to 96 h of recovery (p < 0.05 vs asphyxia + vehicle). The total burden of EDs was associated with reduced numbers of neurons in the caudate nucleus (r² = 0.61, p < 0.05) and CA1/2 hippocampal region (r² = 0.66, p < 0.05). Conclusion: These data demonstrate that TLR7 activation by GDQ modulated blood pressure and suppressed seizures in the early phase of postasphyxial recovery, with subsequent prolonged induction of epileptiform activity. Speculatively, this may reflect delayed loss of early protection or contribute to differential neuronal survival in subcortical regions.     

Novel Constitutive Equation for Predicting Dynamic Recrystallization During Hot Working Considering the Efficiency of Power Dissipation

The efficiency of power dissipation (η) in a dynamic material model has been conventionally used for qualitative predictions to estimate the hot working conditions at which dynamic recrystallization (DRX) is dominant. However, predicting the quantitative value of the DRX fraction (X_DRX) from η remains a challenge. In this paper, a constitutive equation is proposed to quantitatively predict X_DRX using η. The proposed equation for describing X_DRX is derived from the reaction rate equation using the assumption that the DRX rate depends on η. The proposed equation is verified via hot compression tests of equiaxed Ti–6Al–4V ELI alloys (Ti-64) in the (α + β) region. The predicted and experimental X_DRX values are found to be generally consistent with one another, exhibiting an average absolute error of 0.05. Furthermore, the proposed equation provides the same level of prediction accuracy as the conventional Johnson–Mehl–Avrami–Kolmogorov (JMAK) equation. Therefore, the proposed equation can be used to quantitatively predict X_DRX following hot compression tests of equiaxed Ti-64. Moreover, compared with the JMAK equation, the proposed equation is expressed in fewer parameters and constant terms. It is, thus, expected to facilitate the quantitative prediction of X_DRX.

     

Extraction and implementation of muscle synergies in neuro-mechanical control of upper limb movement

This work faces the redundancy problem, a central concern in robotics, in a particular force-producing task by using muscle synergies to simplify the control. We extracted muscle synergies from human electromyograph signals and interpreted the physical meaning of the identified muscle synergies. Based on the human analysis results, we hypothesized a novel control framework that can explain the mechanism of the human motor control. The framework was tested in controlling a pneumatic-driven robotic arm to perform a reaching task. This control method, which uses only two synergies as manipulated variables for driving antagonistic pneumatic artificial muscles to generate desired movements, would be useful to deal with the redundancy problem; thus, suggesting a simple but efficient control for human-like robots to work safely and compliantly with humans.     

Development of flexible displays using back‐channel‐etched In–Sn–Zn–O thin‐film transistors and air‐stable inverted organic light‐emitting diodes

We developed flexible displays using back‐channel‐etched In–Sn–Zn–O (ITZO) thin‐film transistors (TFTs) and air‐stable inverted organic light‐emitting diodes (iOLEDs). The TFTs fabricated on a polyimide film exhibited high mobility (32.9 cm²/Vs) and stability by utilization of a solution‐processed organic passivation layer. ITZO was also used as an electron injection layer (EIL) in the iOLEDs instead of conventional air‐sensitive materials. The iOLED with ITZO as an EIL exhibited higher efficiency and a lower driving voltage than that of conventional iOLEDs. Our approach of the simultaneous formation of ITZO film as both of a channel layer in TFTs and of an EIL in iOLEDs offers simple fabrication process.     

Fabrication of 5.8‐in. OTFT‐driven flexible color AMOLED display using dual protection scheme for organic semiconductor patterning

Abstract— A 5.8‐in. wide‐QQVGA flexible color active‐matrix organic light‐emitting‐diode (AMOLED) display consisting of organic thin‐film transistors (OTFTs) and phosphorescent OLEDs was fabricated on a plastic film. To reduce the operating voltage of the OTFTs, Ta₂O₅ with a high dielectric constant was employed as a gate insulator. Pentacene was used for the semiconductor layer of the OTFTs. This layer was patterned by photolithography and dry‐etched using a dual protection layer of poly p‐xylylene and SiO₂ film. Uniform transistor performance was achieved in the OTFT backplane with QQVGA pixels. The RGB emission layers of the pixels were formed by vacuum deposition of phosphorescent small molecules. The resulting display could clearly show color moving images even when it was bent and operated at a low driving voltage (below 15 V).     

Survey of actual viewing conditions at home and appropriate luminance of LCD‐TV screens

Abstract— To understand actual viewing conditions at home is important for TV design. And the preferred luminance level of LCD TVs under actual viewing conditions is also important in order to obtain both good picture quality and low power consumption. The actual viewing conditions of households and the preferred luminance levels was investigated. In a field test of 83 households, the display luminance, screen illuminance, and viewing locations were measured on site. In laboratory experiments, young and elderly subjects adjusted the luminance of an LCD‐TV screen to their preferred levels under different screen illuminance levels, angular screen sizes, and average luminance levels (ALL) of the images. As a result, two equations, which represent the preferred luminance level of LCD‐TV screens corresponding to different viewing conditions for young and elderly subjects were obtained. When the ALL of the images was 25% and the screen illuminance and angular screen size were set at 100 lx and 20°, respectively, the preferred luminance was 1 60 cd/m² for the young subjects and 248 cd/m² for the elderly subjects. By using the setting of the preferred luminance of an LCD TV under actual viewing conditions, it is possible to conserve energy consumption.